“Shotgun”治疗策略在平坦下降型突发性聋患者中的应用效果评价
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摘要
目的:探究"Shotgun"策略的治疗方案在平坦下降型突发性聋患者中的应用效果。方法 :选择90例于2015年12月—2017年12月在我院耳鼻喉科治疗的平坦下降型突发性聋患者,根据随机数字表法分为两组,各45例,对照组采用金纳多、巴曲酶、激素组治疗方案,观察组采用全身激素、局部激素联合高压氧治疗方案,两组均持续治疗10天,比较治疗前、后两组受损平均纯音听阈、伴发症及不良反应情况。结果:治疗后,两组受损频率的平均纯音听阈、伴发症均较治疗前明显改善,差异有统计学意义(P <0.05);两组平均纯音听阈改善及治疗总有效率比较,差异无统计学意义(P> 0.05);伴发症(耳鸣、耳闷)方面,观察组治疗总有效率高于对照组,差异有统计学意义(χ~2耳鸣=2.07,P=0.038;χ~2耳闷=2.05,P=0.041);两组均未见明显不良反应。结论 :激素联合高压氧治疗方案治疗平坦下降型突发性聋的疗效好,可有效改善患者耳鸣、耳闷伴发症情况,且安全性高。
Objective: To explore the application effect of "Shotgun" treatment strategy in patients with flat descending sudden deafness. Methods: 90 patients with flat descending sudden deafness who were treated in our hospital from December 2015 to December 2017 were selected and randomly divided into two groups, 45 cases each. The patients in the control group were treated with the treatment regimen of Ginaton, batroxobin and hormones, and the patients in the observation group were treated with the treatment regimen of systemic hormones, local hormones combined with hyperbaric oxygen. The patients in the two groups were treated for 10 days. The damaged average pure tone hearing threshold and concomitant symptoms before and after treatment and adverse reactions in the two groups were compared. Results: The damaged average pure tone hearing threshold and concomitant symptoms in the two groups after treatment were significantly improved compared with those before treatment(P<0.05). There were no statistically significant differences in the average pure tone hearing threshold improvement and total effective rate of the treatment between the two groups(P>0.05). In terms of the complications(tinnitus, ear fullness), the total effective rate in the observation group was higher than that in the control group, and the difference was statistically significant(χ~2 tinnitus = 2.07, P=0.038; χ~2 ear fullness = 2.05, P=0.041). There were no obvious adverse reactions in the two groups. Conclusion: Hormones combined with hyperbaric oxygen are effective in the treatment of flat descending sudden deafness, which can effectively improve patients' tinnitus and ear fullness, and have high safety.
Objective: To explore the application effect of "Shotgun" treatment strategy in patients with flat descending sudden deafness. Methods: 90 patients with flat descending sudden deafness who were treated in our hospital from December 2015 to December 2017 were selected and randomly divided into two groups, 45 cases each. The patients in the control group were treated with the treatment regimen of Ginaton, batroxobin and hormones, and the patients in the observation group were treated with the treatment regimen of systemic hormones, local hormones combined with hyperbaric oxygen. The patients in the two groups were treated for 10 days. The damaged average pure tone hearing threshold and concomitant symptoms before and after treatment and adverse reactions in the two groups were compared. Results: The damaged average pure tone hearing threshold and concomitant symptoms in the two groups after treatment were significantly improved compared with those before treatment(P<0.05). There were no statistically significant differences in the average pure tone hearing threshold improvement and total effective rate of the treatment between the two groups(P>0.05). In terms of the complications(tinnitus, ear fullness), the total effective rate in the observation group was higher than that in the control group, and the difference was statistically significant(χ~2 tinnitus = 2.07, P=0.038; χ~2 ear fullness = 2.05, P=0.041). There were no obvious adverse reactions in the two groups. Conclusion: Hormones combined with hyperbaric oxygen are effective in the treatment of flat descending sudden deafness, which can effectively improve patients' tinnitus and ear fullness, and have high safety.
引文
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[9]张聪,唐玲,杨晓琦,等.大剂量巴曲酶治疗平坦型和全聋型突发性聋的疗效观察[J].实用临床医药杂志,2017,21(7):150-151.
[10]杨莉,干强,方红雁,等.糖皮质激素与高压氧治疗高频下降型突发性耳聋的临床疗效观察[J].重庆医学,2017,46(14):1910-1911,1914.
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[12]Michel O.The revised version of the german guidelines“sudden idiopathic sensorineural hearing loss”[J].Laryn gorhinootologie,2011,90(5):290-293.
[2]陈平,唐安洲,郑明华,等.突发性聋不同听力曲线类型的临床特征及疗效分析[J].临床耳鼻咽喉头颈外科杂志,2012,26(22):1043-1046.
[3]中国突发性聋多中心临床研究协作组.中国突发性聋分型治疗的多中心临床研究[J].中华耳鼻咽喉头颈外科杂志,2013,48(5):355-361.
[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头颈外科学分会.突发性聋诊断和治疗指南(2015)[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-447.
[5]余力生,杨仕明.中国突发性聋多中心临床研究工作手册[M].北京:中华医学会耳鼻咽喉科学分会,中华耳鼻咽喉科杂志编辑委员会,2007.
[6]张姝,高晶.突发性聋发病机制的研究进展[J].听力学及言语疾病杂志,2012,20(1):60-63.
[7]陈国郝,张榕,王英歌,等.平坦型突发性聋药物治疗的多中心研究[J].中华耳鼻咽喉头颈外科杂志,2013,48(5):374-378.
[8]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.
[9]张聪,唐玲,杨晓琦,等.大剂量巴曲酶治疗平坦型和全聋型突发性聋的疗效观察[J].实用临床医药杂志,2017,21(7):150-151.
[10]杨莉,干强,方红雁,等.糖皮质激素与高压氧治疗高频下降型突发性耳聋的临床疗效观察[J].重庆医学,2017,46(14):1910-1911,1914.
[11]Stachler RJ,Chandrasekhar SS,Archer SM,et al.Clinical practice guideline:sudden hearing loss[J].Otolaryngol Head Neck Surg,2012,146(S3):S1-S35.
[12]Michel O.The revised version of the german guidelines“sudden idiopathic sensorineural hearing loss”[J].Laryn gorhinootologie,2011,90(5):290-293.