山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 52-55.doi: 10.6040/j.issn.1673-3770.0.2018.408

• 论著 • 上一篇    下一篇

糖皮质激素不同给药方式治疗突发性聋的临床疗效及安全性研究

张俊军1,刘海莉2,刘加福2,秦小奉2,杜洪明1,王厚慧2   

  1. 1.莒县中医医院耳鼻喉科, 山东 莒县276599;
    2.莒县人民医院呼吸内科, 山东 莒县 276599
  • 出版日期:2019-07-20 发布日期:2019-07-22
  • 基金资助:
    山东省医药卫生科技发展计划项目(2017WSA11018)

Clinical efficacy and safety of different methods of administration of glucocorticoids in the treatment of sudden deafness

ZHANG Junjun1, LIU Haili2, LIU Jiafu2, QIN Xiaofeng2, DU Hongming1, WANG Houhui2   

  1. Department of Respiratory Medicine, Yixian People′s Hospital, Jixian County, Jvxian 276599, Shandong, China
  • Online:2019-07-20 Published:2019-07-22

摘要: 目的 观察糖皮质激素不同给药方式治疗突发性聋的临床疗效及安全性。 方法 将耳鼻喉科2017年1月至2018年3月收治的150例突发性聋患者按照住院顺序随机分为3组, 在应用改善微循环、营养神经药物治疗的基础上,鼓室穿刺组加用鼓室穿刺注射糖皮质激素,静脉滴注组加用静脉滴注糖皮质激素,耳后乳突组加用耳后乳突注射糖皮质激素。比较治疗后3组患者听力提高疗效及不良反应情况等。 结果 与治疗前相比,治疗2周后耳后注射糖皮质激素组疗效均优于静脉滴注糖皮质激素与鼓室穿刺注射糖皮质激素组,差异均有统计学意义(P<0.05)。3组不良反应及并发症比较,差异无统计学意义(P>0.05)。 结论 糖皮质激素耳后乳突区局部注射糖皮质激素治疗突发性聋的临床疗效更佳,不良反应发生率低,更安全可靠。

关键词: 突发性聋, 糖皮质激素, 耳后注射, 鼓膜穿刺, 临床疗效

Abstract: Objective The aim of the study was to investigate the clinical efficacy and safety of different methods of glucocorticoid administration in the treatment of sudden deafness. Methods One hundred and fifty patients with sudden deafness admitted in our hospital from January 2017 to March 2018 were randomly divided into three groups according to the hospitalization order. Based on the application of improved microcirculation methods, nutritional neuropharmacology, and tympanostomy, the groups were classified as tympanic glucocorticoid injection group, intravenous drip and intravenous infusion of glucocorticoid group, and postauricular mastoid group with postauricular mastoid injection of glucocorticoids. The improvement in hearing and adverse reactions of the three groups were compared after the completion of treatment. Results A comparison of the three groups before and after 2-weeks of hearing improvement treatment suggests that the effect of glucocorticoid injection in the postauricular mastoid region was better than intravenous infusion or tympanic injection of glucocorticoids, and the difference was observed to be statistically significant (P<0.05). However, no significant differences were observed in the rate of adverse reactions and complications among the three groups (P>0.05). Conclusion Glucocorticoid injection in the posterior mastoid area was found to be better for the treatment of sudden deafness. The incidence of adverse reactions is low, and, hence, the treatment can be deemed reliable and safe.

Key words: Sudden deafness, Corticosteroids, Postauricular injection, Tympanic membrane puncture, Clinical efficacy

中图分类号: 

  • R764.437
[1] 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. doi:10.3760/cma.j.issn.1673-0860.2015.06.002.
[2] 中国突发性聋多中心临床研究协作组, Chinese sudden hearing loss multi-center clinical. 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. doi:10.3760/cma.j.issn.1673-0860.2013.05.002. Chinese sudden hearing loss multi-center clinical. Prospective clinical multi-center study on the treatment of sudden deafness with different typings in china[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2013, 48(5): 355-361. doi:10.3760/cma.j.issn.1673-0860.2013.05.002.
[3] 周长华, 桂明才, 徐丹, 等. 地塞米松耳后注射治疗突发性聋的临床观察[J]. 中国中西医结合耳鼻咽喉科杂志, 2016, 24(2): 99-100,98. doi:10.16542/j.cnki.issn.1007-4856.2016.02.006. ZHOU Changhua, GUI Mingcai, XU Dan, et al. The effects of postauricular dexamethasone injection for sudden hearing loss[J]. Chinese Journal of Otorhinolaryngology in Integrative Medicine, 2016, 24(2): 99-100,98. doi:10.16542/j.cnki.issn.1007-4856.2016.02.006.
[4] 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. doi:10.1002/lary.24834.
[5] Jung da J, Park JH, Jang JH, et al. The efficacy of combination therapy for idiopathic sudden sensorineural hearing loss[J]. Laryngoscope, 2016, 126(8): 1871-1876. doi:10.1002/lary.25751.
[6] 吴思恩, 李清明, 黄素红. 耳后注射甲基泼尼松龙治疗低中频下降型突发性聋的疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2015(10): 928-930. WU Sien LI Qingming HUANG Suhong. Clinical effect on the treatment of the low-middle frequency sudden hearing loss with postaurical injection of methylprednisolone[J]. Journal of Clinical Otorhinolaryngology, 2015(10): 928-930.
[7] 静媛媛, 余力生, 李兴启, 等. 耳后注射复方倍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. doi:10.3969/j.issn.1006-7299.2009.04.012. JING Yuanyuan, YU Lisheng, LI Xingqi, et al. Compound betameth pharmacokinetics in plasma of guinea pig after postaurieal injection[J]. Journal of Audiology and Speech Pathology, 2009, 17(4): 354-357. doi:10.3969/j.issn.1006-7299.2009.04.012.
[8] 兰龙江, 徐珏. 乳突筛区骨膜下注射甲泼尼龙琥珀酸钠治疗常规治疗失败的突发性聋[J]. 中国耳鼻咽喉头颈外科, 2014, 21(6): 287-289. LAN Longjiang, XU Jue. Clinical effect of methyllprednisolone on refractory sudden hearing loss through mastoid cribriform area subperiosteum injection[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2014, 21(6): 287-289.
[9] 孔维佳.耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2005:351-352.
[10] Takumida M, Anniko M. Localization of endotoxin in the inner ear following inoculation into the middle ear[J]. Acta Otolaryngol, 2004, 124(7): 772-777. doi:10.1080/00016480410017459.
[11] 苏金龙.地塞米松鼓室注射对突发性聋患者的影响[J].中国微循环,2009,13(4):303-304.
[12] 张运波, 杨艺全, 习国平, 等. 乳突骨膜下注射甲泼尼龙琥珀酸钠治疗突发性聋[J]. 听力学及言语疾病杂志, 2012, 20(4): 375-376. doi:10.3969/j.issn.1006-7299.2012.04.022.
[13] 徐鸥, 王静妙, 刘砚星, 等. 耳后注射皮质类固醇药物治疗突聋疗效分析[J]. 听力学及言语疾病杂志, 2013, 21(6): 633-634. doi:10.3969/j.issn.1006-7299.2013.06.021.
[14] 卢娜. 三种不同给药途径治疗突发性感音神经性耳聋的效果对比[J]. 山东大学耳鼻喉眼学报, 2015(2): 24-27. doi:10.6040/j.issn.1673-3770.0.2014.316. LU Na. Three different routes of administration in the treatment of sudden sensorineural hearing loss.LU Na. Department[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2015(2): 24-27. doi:10.6040/j.issn.1673-3770.0.2014.316.
[15] 高子雯, 戴艳红, 后婕, 等. 不同局部应用糖皮质激素方式在治疗难治性突发性聋的疗效观察[J]. 中华耳科学杂志, 2017, 15(6): 709-714. doi:10.3969/j.issn.1672-2922.2017.06.020. GAO Ziwen, DAI Yanhong, HOU Jie, et al. Rescue glucocorticoid treatments for refractory sudden sensorineural hearing loss[J]. Chinese Journal of Otology, 2017, 15(6): 709-714. doi:10.3969/j.issn.1672-2922.2017.06.020.
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