摘要
目的观察地塞米松不同给药途径对突发性聋患者的效果影响。方法选取我院2015年6月~2018年6月收治的60例突发性聋患者,用随机数字表法分为对照组和观察组,每组各30例。对照组采用常规疗法结合耳后注射地塞米松治疗,观察组采用相同常规疗法结合鼓室内注射地塞米松治疗,两组均隔日注射1次,共注射5次。治疗前后对两组行纯音听阈测试(PTA),计算平均听阀;观察两组效果、不良反应及患者负面情绪变化;比较两组治疗后生活质量。结果观察组治疗总有效率为83.33%,高于对照组的60.00%,差异有统计学意义(P<0.05);两组治疗后平均听阀较治疗前下降,且观察组治疗后平均听阀低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);两组治疗后焦虑自评量表(SAS)与抑郁自评量表(SDS)评分较治疗前下降,且观察组治疗后评分低于对照组,差异有统计学意义(P<0.05);观察组干预后健康调查简表(SF-36)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论地塞米松鼓室内注射较耳后注射可更有效改善突发性聋患者听力症状,减轻患者负面情绪,提高患者生活质量。
Objective To observe the dosage Dexamethasone different influence on the curative effect of patients with sudden deafness. Methods From June 2015 to June 2018, 60 cases of patients with sudden deafness were selected,they were divided into the control group and the observation group according to random number table method, 30 cases in each group. Ears after injection of Dexamethasone treatment in combination with the control group using conventional therapy, observation group with the same routine therapy combined with drum indoor injection of Dexamethasone treatment, both groups on injection, injection of 5 times. Before and after treatment on two groups of patients with pure tone hearing threshold test(PTA), calculate the average valve; Observe two groups of patients with curative effect, adverse reaction and negative emotions; the two groups after treatment of quality of life were compared. Results The total effective rate observation group in was 83.33%, 60.00% higher than that of control group, the difference was statistically significant(P <0.05). An average of the two groups after treatm ent to listen to valve down, compared with before treatment and observation group, on average, to listen to valve was lower than the control group after treatment, the difference was statistically significant(P<0.05). The incidence of adverse reactions the two groups between, there was no statistically significant difference(P>0.05). Self-evaluation of the two groups after treatment of anxiety scale(SAS) and depression self rating scale(SDS) score was decreased, the score was lower than the control group after treatment and observation group, the difference was statistically significant(P <0.05). After the intervention, health survey profiles(SF-36) score in the observation group were higher than the control group, the difference was statistically significant(P<0.05). Conclusion Dexamethasone drum the ears after injection injection can more effectively improve the symptoms of patients with sudden deafness hearing, alleviate patients′ negative mood, improve patient quality of life.
引文
[1]王淑芳,张莉,张雯雯,等.鼠神经生长因子在突发性耳聋中的疗效观察[J].中华耳科学杂志,2016,14(2):223-228.
[2]汪洋,卢兵,谢彗星.高压氧联合地塞米松治疗突发性耳聋临床效果观察[J].河北医学,2015,21(2):295-297.
[3]刘跃辉,胡国文,邹平.地塞米松和盐酸氨溴索联合鼓室内注射治疗分泌性中耳炎的效果观察[J].中国当代医药,2015,22(4):82-84.
[4]中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科头颈外科学分会.突发性聋的诊断与治疗指南[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-447.
[5]刘文婷,宋江顺,谢景华,等.幼儿chirp-ASSR与纯音听阈测试的相关性研究[J].中华耳科学杂志,2016,14(2):191-194.
[6]Crane RA,Camilon M,Nguyen S,et al.Steroids for treatment of sudden sensorineural hearing loss:a meta-analysis of randomized controlled trials[J].Laryngoscope,2015,125(1):209-217.
[7]冯璐,张新艳,赵刚.中医药配合微量生物电导入刺激治疗儿童混合性焦虑抑郁障碍观察[J].中华中医药学刊,2016,34(8):1978-1980.
[8]李莉,陈善佳,方云华,等.中文版SF-36用于评价亚急性脑卒中患者生存质量的信度和效度[J].中国康复医学杂志,2017,32(5):509-515.
[9]Park JJ,Jeong SW,Lee JW,et al.A Case of sudden deafness with intralabyrinthine hemorrhage intralabyrinthine hemorrhage and sudden deafness[J].J Audiol Otol,2015,9(3):178-181.
[10]钱怡,钟时勋,胡国华,等.突发性耳聋的分型治疗及预后分析[J].重庆医科大学学报,2015,40(8):1159-1163.
[11]李代波,周松,徐文均.鼓室注射地塞米松与耳后骨膜下注射甲强龙治疗突发性聋的疗效及不良反应对比[J].临床耳鼻咽喉头颈外科杂志,2017,31(16):1265-1268.
[12]Maeda Y,Fukushima K,Kariya S,et al.Dexamethasone regulates cochlear expression of deafness-associated proteins myelin protein zero and heat shock protein 70,as revealed by iTRAQ proteomics[J].Otol Neurotol,2015,36(7):1255-1265.
[13]张宇丽,尹桂茹,毕静,等.地塞米松不同给药方式治疗分泌性中耳炎的临床观察[J].中国药房,2016,27(24):3345-3347.
[14]唐艳丽,郭有新,赵明,等.突聋伴糖尿病患者耳后骨膜下注射地塞米松临床疗效观察[J].河北医学,2016,22(2):301-302.
[15]石茭,韩琳,李晶兢,等.耳后给药及鼓室给药外淋巴液药物浓度的实验观察[J].中华耳科学杂志,2016,14(4):540-544.