耳后骨膜下注射甲强龙治疗突发性耳聋的疗效观察
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摘要
目的探讨耳后骨膜下注射甲强龙治疗突发性耳聋临床疗效。方法回顾我院2014年2月～2017年10月期间应用甲强龙治疗的127例突发性耳聋患者,根据甲强龙应用途径分为全身用药组及耳后注射组,对比其临床治疗疗效。结果耳后注射组总体有效率63.24%,全身用药组总体有效率44.07%,差异有统计学意义(P<0.05)。亚组分析显示耳后注射组能明显提高低频下降型突发性耳聋患者总体有效率,而高频下降型、平坦下降型及全聋型组均无差别。结论耳后骨膜下注射甲强龙提高突发性耳聋患者特别是低频下降型总体有效率。
Objective To investigate the clinical curative effect of post-aural subperiosteal injection of methylprednisolone in the treatment of sudden sensorineural hearing loss(SSNHL). Methods From February 2014 to October 2017, a total of 127 patients with SSNHL in our hospital were selected and divided into systemic intravenous infusion group and post-aural injection group according to the application way of methylprednisolone. Post-aural injection group received post-aural injection of methylprednisolone, while systemic intravenous infusion group was intravenous driped of methylprednisolone. Then the overall efficiency was compared between the two groups. ResultsThe overall efficiency rate of post-aural injection group was 63.24%, while that of intravenous infusion group was 44.07%. The results were statistically significant difference(P < 0.05). Subgroup analysis showed that post-aural injection group could significantly improve the overall efficiency of patients with low-frequency loss type, while there was no difference between high-frequency loss type, flat loss type and total loss type. Conclusion Post-aural injection of methylprednisolone as a safe treatment for SSNHL is more effective compared with systemic administration of methylprednisolone, especially for low-frequency loss.
Objective To investigate the clinical curative effect of post-aural subperiosteal injection of methylprednisolone in the treatment of sudden sensorineural hearing loss(SSNHL). Methods From February 2014 to October 2017, a total of 127 patients with SSNHL in our hospital were selected and divided into systemic intravenous infusion group and post-aural injection group according to the application way of methylprednisolone. Post-aural injection group received post-aural injection of methylprednisolone, while systemic intravenous infusion group was intravenous driped of methylprednisolone. Then the overall efficiency was compared between the two groups. ResultsThe overall efficiency rate of post-aural injection group was 63.24%, while that of intravenous infusion group was 44.07%. The results were statistically significant difference(P < 0.05). Subgroup analysis showed that post-aural injection group could significantly improve the overall efficiency of patients with low-frequency loss type, while there was no difference between high-frequency loss type, flat loss type and total loss type. Conclusion Post-aural injection of methylprednisolone as a safe treatment for SSNHL is more effective compared with systemic administration of methylprednisolone, especially for low-frequency loss.
引文
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[11]王英歌,张榕,许元腾,等.不同年龄及不同类型突发性耳聋患者近期疗效观察[J].中华耳科学杂志,2012,10(3):364-367.
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[14]王翡,刘雪梅,朱玉华.耳后给药治疗中高频下降型突发性聋的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(4):359-361.
[2]张晓彤,许珉,段茂利,等.突发性聋临床流行病学分析[J].中华耳科学杂志,2009,7(2):152-156.
[3]岑锦添,曾祥丽,黎志成,等.突发性耳聋治疗过程中听力损失加重的临床特点及病因分析[J].中山大学学报(医学科学版),2014,35(6):874-879.
[4]周华容,刘涛,刘锐越.声频共振辅助治疗突发性耳聋的meta分析[J].中国医药科学,2013,3(17):76-78.
[5]刘文,陈鸿雁,钟朝晖.局部和全身应用糖皮质激素治疗突发性耳聋的Meta分析[J].重庆医科大学学报,2012,37(10):895-899.
[6]屈永涛,张慧平,陈红耀,等.鼓室内联合全身应用糖皮质激素治疗全聋型突发性聋[J].中华耳科学杂志,2016,14(3):388-391.
[7]赵群,王英力,王洪芹.耳后注射甲强龙对平坦型突发性聋疗效分析[J].中华耳科学杂志,2016,14(1):79-81.
[8]易虹.耳后注射甲强龙对全聋型突发性聋疗效分析[J].中国医药科学,2017,13(8):21-24.
[9]中华医学会耳鼻咽喉头颈外科学分会中华耳鼻咽喉头颈外科杂志编辑委员会.突发性聋诊断和治疗指南(2015)[J].中华耳鼻喉头颈外科杂志,2015,50(6):443-447.
[10]马芙蓉,谢立峰,赵一鸣.突发性耳聋预后因素回归树分析[J].中国耳鼻咽喉头颈外科,2005(9):577-579.
[11]王英歌,张榕,许元腾,等.不同年龄及不同类型突发性耳聋患者近期疗效观察[J].中华耳科学杂志,2012,10(3):364-367.
[12]Wilson WR,Byl FM,Laird N.The efficacy of steroids in the treatment of idiopathic sudden hearing loss.A double-blind clinical study[J].Arch Otolaryngol,1980,106(12):772-776.
[13]Parnes LS,Sun AH,Freeman DJ.Corticosteroid pharmacokinetics in the inner ear fluids:an animal study followed by clinical application[J].Laryngoscope,1999,109(7 Pt 2):1-17.
[14]王翡,刘雪梅,朱玉华.耳后给药治疗中高频下降型突发性聋的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(4):359-361.