山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (1): 15-18.doi: 10.6040/j.issn.1673-3770.0.2014.284

• 论著 • 上一篇    下一篇

鼓室激素注射为初始治疗的突发性聋听力恢复的时间规律

张彩霞1,2, 刘阳云2, 陈志喜3, 江文2, 李正贤2, 陈琼2, 常恩格2   

  1. 1. 湖南师范大学医学院, 湖南 长沙 410003;
    2. 湖南师范大学医学院第二附属医院/解放军第163中心医院耳鼻喉科, 湖南 长沙 410003;
    3. 粤北人民医院耳鼻咽喉头颈外科, 广东 韶关 512026
  • 收稿日期:2014-08-25 出版日期:2015-02-16 发布日期:2015-02-16
  • 通讯作者: 刘阳云。E-mail:lyyundr@aliyun.com E-mail:lyyundr@aliyun.com
  • 作者简介:张彩霞。E-mail:1309642400@qq.com

Time pattern of audiological recoverey with intratympanic steroid injection as primary treatment for sudden sensorineural hearing loss

ZHANG Cai-xia1 2, LIU Yang-yun2, CHEN Zhi-xi3, JIANG Wen2, LI Zheng-xian2, CHEN Qiong2, CHANG En-ge2   

  1. 1. The Medical College of Hunan Normal University, Changsha 410003, Hunan, China;
    2. Department of Otolaryngology, the Second Affiliated Hospital of Hunan Normal University Medical College(No. 163 Hospital of PLA), Changsha 410003, Hunan, China;
    3. Department of Otolaryngology & Head and Neck Surgery, Yuebei People's Hospital, Shaoguan 512026, Guangdong, China
  • Received:2014-08-25 Online:2015-02-16 Published:2015-02-16

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摘要： 目的 探讨鼓室激素注射作为初始治疗突发性聋患者方案的听力恢复时间规律,寻求最佳鼓室给药时机。方法 将突发性聋患者135例纳入研究,均接受为期2周的全身激素治疗。其中63例仅接受全身激素治疗,另72例在全身激素治疗开始的同时联合鼓室内激素注射。所有病例随访2个月。结果 治疗后第3天、第7天、第14天、1个月、2个月每个时间点两组间总有效率差异均无统计学意义。全身激素治疗联合鼓室注射组第7天与第14天疗效差异无统计学意义(P=0.065),而单纯全身激素治疗者第7天与第14天疗效比较差异有统计学意义(P=0.029)。结论 鼓室激素注射联合全身激素治疗作为初始治疗方案,其疗效并不优于单纯全身激素治疗,但听力改善峰值的时间前者总体早于后者。

关键词: 恢复时间规律, 鼓室注射, 时机, 突发性聋

Abstract: Objective To explore the time pattern of audiological recovery with intratympanic steroid injection as primary treatment for sudden sensorineural hearing loss (SSNHL) to define best strategy. Methods All 135 patients underwent a two-week systemic steroid therapy, while 72 of them received extra intratympanic injection in the mean time. All cases were followed up 2 months. Results No difference in total effective rates between the two treatments on 3rd day, 7th day,14th day and 1 month was noted. There was no difference between the 7th day and 14th day in combined treatment was noted (P=0.065) but not in systemic steroid therapy alone(P=0.029). Conclusion As a primary treatment, the curative effects between the intratympanic steroid administration and systemic steroid therapy shows no difference. The peaked time of hearing improvement of the former is earlier than that of the latter.

Key words: Intratympanic steroid injection, Time pattern of audiological recovery, Sudden sensorineural hearing loss (SSNHL), Primary treatment

中图分类号: 

  • R764.43
[1] 韩东一,杨仕明.开展中国突发性聋多中心临床研究意义重大[J].中华耳鼻咽喉头颈外科杂志,2013,48(5):353-354. HAN Dongyi, YANG Shiming. Signality on developing chinese clinical multi-center study on sudden deafness[J]. Chin J Otorhinolarynol Head Neck Surg, 2013, 48(5):353-354.
[2] 韩德民.规范突发性聋的诊断与治疗[J]. 中国医学文摘:耳鼻咽喉科学,2008,23(1):1-2. HAN Deming. Standardizing diagnosis and treatment of sudden deafness[J]. Chin Med Digest Otolaryngology, 2008, 23(1):1-2.
[3] 刘阳云,江文,毛坤华,等.突发性聋疗效评估的时机探讨[J].临床耳鼻咽喉头颈外科杂志, 2012,26(7):308-311. LIU Yangyun, JIANG Wen, MAO Kunhua, et al. The evaluated time of curative effect on sudden deafness[J]. Clin J Otorhinolarynol Head Neck Surg, 2012, 26(7):308-311.
[4] 刘阳云, 江文,毛坤华,等.突发性聋愈后的时间规律及临床意义[J].听力学及言语疾病杂志,2013,21(3):241-243. LIU Yangyun, JIANG Wen, MAO Kunhua, et al. Recovered time pattern and clinical significance on sudden deafness[J]. J Audiol Speech Pathol, 2013, 21(3):241-243.
[5] 刘阳云,江文,毛坤华,等.高压氧治疗突发性聋治疗方案与疗程的选择[J]. 山东大学耳鼻喉眼学报,2012,26(1):70-72. LIU Yangyun, JIANG Wen, MAO Kunhua, et al. The choice of hyperbaric oxygen therapy plan and time of therapy on sudden deafness[J]. J Otolaryngol Ophthalmol Shandong Univ, 2012, 26(1):70-72.
[6] 周义德,郑贵亮,周容珏,等.早期经鼓室应用类固醇激素治疗"不良预后"突发性聋[J]. 中华耳科学杂志,2012,10(2):160-163. ZHOU Yide, ZHENG Guiliang, ZHOU Rongjue, et al. Early transtympanic steroid injection in patients with'poor prognosis'idiopathic sensorineural sudden hearing loss[J]. Chin J Otology, 2012, 10(2):160-163.
[7] 张志坚,华清泉,王新春,等.全身应用联合鼓室注射糖皮质激素治疗重度和极重度突发性聋[J]. 听力学及言语疾病杂志,2012,20(5):450-452. ZHANG Zhijian, HUA Qingquan, WANG Xinchun, et al.Combined of intratympanic and systemic use glucocorticoid for the treatment of severe to profound idiopathic sudden sensorineural hearing loss[J]. J Audiol Speech Pathol, 2012, 20(5):450-452.
[8] Dispenza F, De Stefano A, Costantino C, et al.Sudden sensorineural hearing loss: results of intratympanic steroids as salvage treatment[J]. Am J Otolaryngol, 2013, 34(4):296-300.
[9] Stachler R J, Chandrasekhar S S, Archer S M, et al.Clinical practice guideline:sudden hearing loss[J].Otolaryngol Head Neck Surg, 2012, 146:S1-S35.
[10] 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. 突发性聋的诊断和治疗指南(2005年,济南) [J]. 中华耳鼻咽喉头颈外科杂志,2006,41(5): 325. Editorial board of Chinese Journal of Otorhinolaryngology Head and neck surgery.Chinese Medical Association of Otorhinolaryngology Head and Neck Surgery. Guidelines for the diagnosis and treatment on sudden deafness[J]. Chin J Otorhinolarynol Head Neck Surg, 2006, 41 (5): 325.
[11] Plaza G, Herraiz C. Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy[J]. Otolaryngol Head Neck Surg, 2007, 137(1): 74-78.
[12] Roebuck J, Chang C Y. Efficacy of steroid injection on idiopathic sudden sensorineural hearing loss[J]. Otolaryngol Head Neck Surg, 2006, 135(2):276-279.
[13] Kilic R, Safak M A, Oguz H, et al. Intratympanic methylprednisolone for sudden sensorineural hearing loss[J]. Otol Neurotol, 2007, 28(3):312-316.
[14] Choung Y H, Park K, Shin Y R, et al. Intratympanic dexamethasone injection for refractory sudden sensorineural hearing loss[J]. Laryngoscope, 2006, 116(5):747-752.
[15] Haynes D S, O'Malley M, Cohen S, et al. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy[J]. Laryngoscope, 2007, 117(1):3-15.
[16] Slattery W H, Fisher L M, Iqbal Z, et al. Intratympanic steroid injection for treatment of idiopathic sudden hearing loss[J]. Otolaryngol Head Neck Surg, 2005, 133(2):251-259.
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