鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗重度以上突发性耳聋的效果观察
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摘要
目的:探讨鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗重度以上突发性耳聋的临床效果。方法:选取本院耳鼻喉科2014年10月-2017年9月收治的重度以上突发性耳聋患者48例,按照随机数字表法将其分为观察组和对照组,各24例。对照组为常规治疗(静脉注射甲强龙、前列地尔,口服甲磺酸倍他司汀、甲钴胺),观察组在对照组的基础上给予鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗,比较两组患者临床疗效、治疗前后纯音听阈值及不良反应发生情况。结果:治疗后,观察组的总有效率为83.33%,高于对照组的58.33%,差异有统计学意义(x~2=4.707,P=0.030)。两组患者治疗前的纯音听阈值比较,差异无统计学意义(P>0.05);两组患者治疗后的纯音听阈值均明显下降,且观察组患者听力改善明显优于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗重度以上突发性耳聋可显著提高临床效果,患者的听力改善更显著,不良反应发生率未明显提高,值得推广。
Objective:To analyze the clinical effect of tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone in the treatment of severe sudden deafness.Method:A total of 48 patients with severe sudden deafness admitted from October 2014 to September 2017 in department of otolaryngology of our hospital were selected.According to the random number table method,they were divided into observation group and control group,24 cases in each group.The control group was given conventional treatment(intravenous injection of Methylprednisolone and Alprostadil,oral Betahistine Mesylate and Mecobalamin).The observation group was given tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone treatment on the basis of the control group.The clinical effect,the threshold of pure tone audition and the incidence of adverse reactions before and after treatment were compared between the two groups.Result:After treatment,the total effective rate of clinical effect in the observation group was 83.33%,which was higher than 58.33% of the control group,the difference was statistically significant( x~2=4.707,P=0.030).There was no significant difference in the pure tone audition threshold between the two groups before treatment(P>0.05);after treatment,the threshold of pure tone audition in the two groups were significantly decreased,the hearing improvement of the observation group was better than that of the control group,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone in the treatment of severe sudden deafness can significantly improve the clinical efficacy,the patient's hearing improvement is more significant,the incidence of adverse reactions did not increase significantly,and it is worth promoting.
Objective:To analyze the clinical effect of tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone in the treatment of severe sudden deafness.Method:A total of 48 patients with severe sudden deafness admitted from October 2014 to September 2017 in department of otolaryngology of our hospital were selected.According to the random number table method,they were divided into observation group and control group,24 cases in each group.The control group was given conventional treatment(intravenous injection of Methylprednisolone and Alprostadil,oral Betahistine Mesylate and Mecobalamin).The observation group was given tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone treatment on the basis of the control group.The clinical effect,the threshold of pure tone audition and the incidence of adverse reactions before and after treatment were compared between the two groups.Result:After treatment,the total effective rate of clinical effect in the observation group was 83.33%,which was higher than 58.33% of the control group,the difference was statistically significant( x~2=4.707,P=0.030).There was no significant difference in the pure tone audition threshold between the two groups before treatment(P>0.05);after treatment,the threshold of pure tone audition in the two groups were significantly decreased,the hearing improvement of the observation group was better than that of the control group,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone in the treatment of severe sudden deafness can significantly improve the clinical efficacy,the patient's hearing improvement is more significant,the incidence of adverse reactions did not increase significantly,and it is worth promoting.
引文
[1]徐青青,林枫,李耀荣,等.鼓室内注射甲强龙治疗突发性耳聋的疗效[J].天津医药,2013,25(1):34-35.
[2]胡焱,黄庆琳,傅江涛,等.耳后与鼓室注射甲强龙治疗难治性突发性耳聋的疗效及对血糖的影响[J].现代实用医学,2017,29(4):523-525.
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[6]张红茹,吴文,赵丽英,等.突发性耳聋相关危险因素分析[J].中国耳鼻咽喉颅底外科杂志,2017,23(2):129-132.
[7]中华耳鼻咽喉头颈外科杂志编辑委员会.突发性聋的诊断和治疗指南(2015)[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-446.
[8]伦杰,张亚楠,薛建军.突发性耳聋患者临床治疗效果及相关影响因素分析[J].中国耳鼻咽喉颅底外科杂志,2016,22(3):198-202.
[9]陈锦贤,林楚标,陈伟龙.鼓室注射不同浓度糖皮质激素联合全身应用糖皮质激素治疗重度以上突发性耳聋的疗效分析[J].中国现代医药杂志,2017,19(12):83-85.
[10]耿萍,陈亚权.鼓室注射与静脉滴注甲泼尼龙琥珀酸钠治疗突发性耳聋的疗效对比研究[J].现代药物与临床,2017,32(6):1105-1108.
[11]廖慧群.甲强龙鼓室注射治疗突发性耳聋的病案质量分析[J].中国病案,2014,15(1):28-29.
[12]金凤桐,傅江涛,王娅婷,等.前列地尔联合鼓室注射地塞米松治疗突发性耳聋的临床疗效及对血液流变学的影响[J].中国现代医生,2017,55(6):78-81.
[13]冯勇,周连仲,王明辉.耳后注射甲基强的松龙治疗突发性耳聋的临床观察[J].医学信息,2013,26(5):338.
[14]胡永成,邓成柳.甲强龙鼓室注射在难治性突发性耳聋治疗中的应用[J].中国现代药物应用,2017,11(1):17-19.
[15]李丹.鼓室注射甲强龙联合口服皮质类固醇治疗重度与极重度突发性耳聋的临床分析[J].中国耳鼻咽喉颅底外科杂志,2016,22(3):244-246.
[16]李晓娜,李玉杰,于敏,等.耳后注射甲泼尼龙治疗特发性耳聋的疗效及对患者血液流变学和血浆Hcy水平的影响[J].中华全科医学,2018,16(1):72-74.
[17]索良东,郭俊杰.耳后注射甲强龙与鼓室内注射甲强龙治疗突发性耳聋的疗效分析[J].内蒙古医学杂志,2016,48(7):867-869.
[18]申迹,项锦银.早期鼓室注射联合全身应用糖皮质激素对突发性耳聋的疗效探讨[J].重庆医学,2017,46(6):789-791,795.
[19]徐春来.糖皮质激素三种给药途径治疗突发性耳聋疗效分析[J].吉林医学,2017,38(6):1114-1115.
[20]邓炳辉.单用激素治疗突发性耳聋的两种对比[J].临床医学工程,2011,18(8):1238-1239.
[21]林运娟,余力生.大鼠耳后和肌肉注射地塞米松后内耳组织药物浓度分析[J].中国耳鼻咽喉头颈外科杂志,2009,16(7):381-384.
[22]静媛媛,余力生,李兴启.耳后注射复方陪他米松豚鼠血浆中药代动力学特征[J].听力学及言语疾病杂志,2009,17(4):354-357.
[2]胡焱,黄庆琳,傅江涛,等.耳后与鼓室注射甲强龙治疗难治性突发性耳聋的疗效及对血糖的影响[J].现代实用医学,2017,29(4):523-525.
[3]孟祥宇,马义,付士丽,等.前列地尔联合鼓室内注射地塞米松治疗突发性耳聋的临床疗效分析[J].世界复合医学,2017,3(1):27-29,88.
[4]岑迎贺.耳内镜下鼓室注射甲强龙治疗中重度突发性耳聋的疗效观察[J].中国现代药物应用,2017,11(12):103-105.
[5]赵芳.对比分析耳后注射甲强龙与鼓室内注射甲强龙治疗突发性耳聋的疗效[J/OL].现代医学与健康研究电子杂志,2018,2(1):21,23.
[6]张红茹,吴文,赵丽英,等.突发性耳聋相关危险因素分析[J].中国耳鼻咽喉颅底外科杂志,2017,23(2):129-132.
[7]中华耳鼻咽喉头颈外科杂志编辑委员会.突发性聋的诊断和治疗指南(2015)[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-446.
[8]伦杰,张亚楠,薛建军.突发性耳聋患者临床治疗效果及相关影响因素分析[J].中国耳鼻咽喉颅底外科杂志,2016,22(3):198-202.
[9]陈锦贤,林楚标,陈伟龙.鼓室注射不同浓度糖皮质激素联合全身应用糖皮质激素治疗重度以上突发性耳聋的疗效分析[J].中国现代医药杂志,2017,19(12):83-85.
[10]耿萍,陈亚权.鼓室注射与静脉滴注甲泼尼龙琥珀酸钠治疗突发性耳聋的疗效对比研究[J].现代药物与临床,2017,32(6):1105-1108.
[11]廖慧群.甲强龙鼓室注射治疗突发性耳聋的病案质量分析[J].中国病案,2014,15(1):28-29.
[12]金凤桐,傅江涛,王娅婷,等.前列地尔联合鼓室注射地塞米松治疗突发性耳聋的临床疗效及对血液流变学的影响[J].中国现代医生,2017,55(6):78-81.
[13]冯勇,周连仲,王明辉.耳后注射甲基强的松龙治疗突发性耳聋的临床观察[J].医学信息,2013,26(5):338.
[14]胡永成,邓成柳.甲强龙鼓室注射在难治性突发性耳聋治疗中的应用[J].中国现代药物应用,2017,11(1):17-19.
[15]李丹.鼓室注射甲强龙联合口服皮质类固醇治疗重度与极重度突发性耳聋的临床分析[J].中国耳鼻咽喉颅底外科杂志,2016,22(3):244-246.
[16]李晓娜,李玉杰,于敏,等.耳后注射甲泼尼龙治疗特发性耳聋的疗效及对患者血液流变学和血浆Hcy水平的影响[J].中华全科医学,2018,16(1):72-74.
[17]索良东,郭俊杰.耳后注射甲强龙与鼓室内注射甲强龙治疗突发性耳聋的疗效分析[J].内蒙古医学杂志,2016,48(7):867-869.
[18]申迹,项锦银.早期鼓室注射联合全身应用糖皮质激素对突发性耳聋的疗效探讨[J].重庆医学,2017,46(6):789-791,795.
[19]徐春来.糖皮质激素三种给药途径治疗突发性耳聋疗效分析[J].吉林医学,2017,38(6):1114-1115.
[20]邓炳辉.单用激素治疗突发性耳聋的两种对比[J].临床医学工程,2011,18(8):1238-1239.
[21]林运娟,余力生.大鼠耳后和肌肉注射地塞米松后内耳组织药物浓度分析[J].中国耳鼻咽喉头颈外科杂志,2009,16(7):381-384.
[22]静媛媛,余力生,李兴启.耳后注射复方陪他米松豚鼠血浆中药代动力学特征[J].听力学及言语疾病杂志,2009,17(4):354-357.