全身或鼓室内应用激素治疗突发性耳聋的疗效及预后影响因素研究
发布时间：2018-10-31 20:01
【摘要】：目的：观察全身或鼓室内注射类固醇激素治疗突发性聋的疗效，比较鼓室内注射（初始治疗）与全身使用激素后再鼓室内注射（补充治疗）的疗效，探讨分析影响突发性聋预后的相关因素。 方法：回顾性分析被确诊为突发性聋的156例患者，其中初始治疗组78例和全身+补充治疗（全身使用激素后再鼓室内注射78例。初始治疗组注射类固醇激素1次/d，1周为1疗程，1-4疗程；全身+补充治疗组全身静滴类固醇激素，10d后改为鼓室内给药。两组同时静滴丹参(16ml／d)，加或不加高压氧治疗。治疗前和治疗后每周复查纯音测听(pure tone average，PTA)。随访3个月。 结果：按PTA恢复≥15dBHL为有效，初始治疗有效率73.1%，全身+补充治疗有效率为53.8%，经χ2检验，差异有统计学意义（P＜0.05）。按PTA恢复≥10dBHL为有效，初始治疗76.9%，全身+补充治疗为64.1%，经χ2检验，差异无统计学意义（P㧐0.05）。预后相关因素分析表明：患者性别、年龄、治疗前听力水平及激素的两种治疗方式与预后无明显相关性（P㧐0.05）。初诊时间、伴耳鸣、眩晕、听力图类型及高压氧治疗等因素与预后相关。从初诊时间上来看，初诊时间3d有效率为73.0％，3-7d有效率为69.4％，7-14d有效率为44.4％，14d有效率为36.4％，3d与3-7d相比较，疗效分别为73.0％和69.4％，差异无统计学意义（P㧐0.05），7-14d与14d以上相比较，差异无统计学意义（P㧐0.05），7d以内和7d以上比较，差异有统计学意义（P＜0.05）。从耳鸣来看，伴耳鸣有效率44．4％，，无耳鸣有效率71．2％，差异有统计学意义（P＜0.05）。从眩晕来看，伴眩晕有效率49．3％，无眩晕有效率74．2％，差异有统计学意义（P＜0.05）。从听力图类型上看，上升型（低频型）、平坦型、下降型（高频型）和全聋型有效率分别为64.9%、56.6%、55.6%、50.0%，上升型的有效率与其它型相比，差异有统计学意义（P＜0.05）。从高压氧治疗来看，同时给予高压氧治疗有效率74．2％，无高压氧治疗有效率55.0％，差异有统计学意义（p0．05)，同时给予高压氧治疗疗效好。 结论：全身或鼓室内注射类固醇激素治疗突发性聋均有效。初始鼓室内注射类固醇激素能达到或超过全身治疗的效果，鼓室内注射类固醇激素是一种安全、耐受性良好的治疗突发性聋的方式，可以把初始治疗作为首选治疗。发病到治疗1周后预后差。不同的听力图类型是影响突发性聋预后的重要因素，上升型预后好。伴有耳鸣、眩晕的患者预后较差。药物治疗同时给予高压氧治疗疗效好。
[Abstract]:Objective: to observe the effect of systemic or intratympanic steroid injection in the treatment of sudden deafness, and to compare the efficacy of intratympanic injection (initial treatment) with that of systemic steroid injection (supplementary therapy). Objective: to investigate the factors related to the prognosis of sudden deafness. Methods: 156 patients with sudden deafness were analyzed retrospectively, including 78 cases in the initial treatment group and 78 cases in the systemic supplementation group. In the initial treatment group, steroid hormone was injected once a week for a course of treatment, 1-4 courses of treatment, and systemic infusion of steroid hormone was changed to intratympanic administration after 10 days in the whole body supplementation group. In both groups, salvia miltiorrhiza (16ml/d) was given intravenously with or without hyperbaric oxygen. Pure tone audiometry (pure tone average,PTA) was performed before and after treatment. Follow-up for 3 months. Results: according to the recovery of PTA 鈮
本文编号：2303383
[Abstract]:Objective: to observe the effect of systemic or intratympanic steroid injection in the treatment of sudden deafness, and to compare the efficacy of intratympanic injection (initial treatment) with that of systemic steroid injection (supplementary therapy). Objective: to investigate the factors related to the prognosis of sudden deafness. Methods: 156 patients with sudden deafness were analyzed retrospectively, including 78 cases in the initial treatment group and 78 cases in the systemic supplementation group. In the initial treatment group, steroid hormone was injected once a week for a course of treatment, 1-4 courses of treatment, and systemic infusion of steroid hormone was changed to intratympanic administration after 10 days in the whole body supplementation group. In both groups, salvia miltiorrhiza (16ml/d) was given intravenously with or without hyperbaric oxygen. Pure tone audiometry (pure tone average,PTA) was performed before and after treatment. Follow-up for 3 months. Results: according to the recovery of PTA 鈮
本文编号：2303383
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