[1]李丽娟,杨引通△,罗家胜,等.耳后注射甲泼尼龙琥珀酸钠在低频下降型突发性聋治疗中的应用*[J].陕西医学杂志,2020,49(5):595-598.
　LI Lijuan,YANG Yintong,LUO Jiasheng,et al.Application of methylprednisolone sodium succinate injection in treatment of low-frequency descending sudden deafness[J].,2020,49(5):595-598.
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耳后注射甲泼尼龙琥珀酸钠在低频下降型突发性聋治疗中的应用*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年5期
页码:
595-598
栏目:
临床研究
出版日期:
2020-05-05

文章信息/Info

Title:
Application of methylprednisolone sodium succinate injection in treatment of low-frequency descending sudden deafness
文章编号:
DOI:10.3969/j.issn.10007377.2020.05.023
作者:
李丽娟; 杨引通△; 罗家胜; 段学军; 高卓平; 陈 鹏; 郭长林; 刘 军; 朱国霞; 霍美旭
西安市第四医院耳鼻咽喉科(西安710004)
Author(s):
LI Lijuan; YANG Yintong; LUO Jiasheng; et al.
Department of Otorhinolaryngology,the Fourth Hospital of Xi'an(Xi'an 710004)
关键词:
突发性聋;  治疗;  甲泼尼龙琥珀酸钠;  耳后局部注射;  疗效;  不良反应
Keywords:
Sudden deafness;  Therapy;  Methylprednisolone sodium succinate;  Postaurical local injection;  Therapeutic effect;  Adverse reaction
分类号:
R764.5
文献标志码:
A
摘要:
目的:探讨耳后注射甲泼尼龙琥珀酸钠治疗低频下降型突发性聋的临床效果,寻找更有效、更安全的激素给药途径。方法:240例低频下降型突发性聋患者随机分为研究组(128例)和对照组(112例),研究组:耳后局部注射甲泼尼龙琥珀酸钠40 mg,1次/2 d,冲击治疗,10 d共5次; 对照组:全身应用激素(地塞米松10 mg,3 d,5 mg,3 d)冲击治疗,两组同时给予5%葡萄糖250 ml加金纳多105 mg静滴,1次/d,治疗10 d后复查听力。比较两组患者疗效以及全身并发症发生情况。结果:研究组总有效率96.9%,对照组总有效率94.6%,两组总有效率比较差异无统计学意义(P>0.05)。两组间不良反应发生率(7.0%与24.1%)比较差异有统计学意义(P<0.05)。两组治疗前平均听阈(250、500、1000 Hz)比较,差异无统计学意义(P>0.05); 两组治疗前后平均听阈差值比较,差异有统计学意义(P<0.05)。结论:低频下降型突发性聋患者局部应用激素冲击治疗较单纯全身应用效果好,并发症少,突发性聋患者局部应用激素可作为全身应用激素的补救、序贯治疗以及部分患者的替代治疗方法。
Abstract:
Objective:To investigate the clinical effect of methylprednisolone sodium succinate injection in the treatment of low-frequency descending sudden deafness,and to find a more effective and safe way of hormone administration. Methods: 240 cases of sudden deafness with low-frequency descent were randomly divided into study group(128 cases)and control group(112 cases). In study group,methylprednisolone sodium succinate(40mg)was injected into the posterior part of the ear,once every other day,5 times in 10 days. In control group,systemic hormone(dexamethasone 10mg for three days,5mg for another three days)was given. The two groups were given 5% glucose 250 ml and Ginaton 105 mg intravenous drip once a day. After 10 days of treatment,the hearing was reexamined. The curative effect and systemic complications of the two groups were observed and compared. Results: The total effective rate of study group was 96.9%,that of control group was 94.6%,there was no significant difference in the total effective rate between the two groups(P>0.05). The difference in the incidence of complications between the two groups was statistically significant(P<0.05). The average hearing threshold(250,500,1000 Hz)before treatment was compared between the two groups,and the difference was statistically significant(P>0.05). There was statistically significant difference in the average hearing threshold difference before and after treatment between the two groups(P<0.05). Conclusion:Local application of hormonal shock therapy in the treatment of patients with low-frequency descending sudden deafness is more effective than simple systemic application,with fewer complications. It can be used as a systemic hormone remedy,sequential treatment and alternative treatment for some patients.

参考文献/References:

[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.突发性聋的诊断和治疗指南[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-446.
[2] 陈琴香.长春西汀治疗突发性耳聋35例[J].陕西医学杂志,2017,46(1):119-121
[3] 刘 璐,钟时勋.糖皮质激素鼓室给药治疗突发性聋的现状分析[J].中华耳科学杂志,2015,13(1):176-178.
[4] 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.
[5] 李欣倩,王卫华,马兆鑫.糖皮质激素耳后注射治疗突发性聋的基础与临床研究[J].国际耳鼻咽喉头颈外科杂志,2018,42(6):345-348.
[6] 田永远,吴学志,张安东,等.清肝通窍汤治疗肝火上扰型暴聋患者临床研究[J].陕西中医,2018,39(11):1548-1550,1568.
[7] Rauch SD,Halpin CF.Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss:a randomized trial[J].JAMA,2011,305(20):2071-2079.
[8] Battaglia A,Burchette R.Combination therapy(intratympanic dexamethasone+high-dose prednisone taper)for the treatment of idiopathic sudden sensorineural hearing loss:Otol[J]. Neurotol,2008,29(4):453-460.
[9] 成福香,王冠宇,赵崎慧.耳后注射在低频下降型感音神经性聋患者中的应用研究[J].陕西医学杂志,2016,45(7):811-812.
[10] 王海茹,王海涛,郝 玲.耳后与全身应用糖皮质激素治疗突发性耳聋系统评价与Meta分析[J].中华耳科学杂志,2018,16(5):669-675.
[11] 陈建伟,刘 蕾.糖皮质激素耳后注射与全身用药在低频突发性耳聋中的疗效[J].临床医药文献电子杂志,2017,4(3):568-569.
[12] 党雅斌,张立刚,张全安.两种注射治疗方法对突发性聋的疗效分析[J].中国听力语言康复科学杂志,2016,14(1):13-16.
[13] 樊迎春,陈丽芳.耳后注射甲泼尼龙琥珀酸钠治疗突发性聋[J].中国耳鼻咽喉头颈外科,2018,25(9):494-496.
[14] Li H,Feng G.Intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss after failure of conventional therapy:a meta-analysis of randomized,controlled trials[J].Clin Ther,2015,37(1):178-187.
[15] 梁 振,余力生,夏瑞明.全频突发性聋的分型探讨[J].中华耳鼻咽喉头颈外科杂志,2010,45(4):282-286.
[16] 王春花,王小锐,康艳霞,等.单侧低中频下降型突发性聋预后相关分析[J]. 中华耳科学杂志,2014,34(4):603-607.
[17] Garduno-Anaya MA,Couthino DTH,Hinojosa G,et al. Dexamethasone inner ear perfusion by intratympanic injection in unilateral Meniere's disease:a two-year prospective,placebo-controlled,double-blind,randomized trial[J]. Otolaryngol Head Neck Surg,2005,133:285-294.
[18] Ohlemiller KK,Rice ME,Gagnon PM.Strial microvascular pathology and age-associated endocochlear potential decline in NOD congenic mice[J]. Hear Res,2008,244,85-97.
[19] Stachler RJ,Chandrasekhar SS,Archer SM,et al Clinical practice guideline:sudden hearing loss[J]. Otolaryngol Head Neck Surg,2012,146,S1-S35.
[20] 陈敬彩,查小雨,杨 军,等.地塞米松磷酸钠注射液不同给药途径治疗突发性聋的疗效分析[J].中国耳鼻咽喉头颈外科,2018,25(12):664-666.
[21] Wang YX,Han L,Diao TX,et al.A comparison of systemic and local dexamethasone administration:From perilymph/cochlea concentration to cochlear distribution[J].Hearing Research,2018,370(2018)1-10.
[22] 刘 文,黄晓悫.耳后注射甲泼尼龙琥珀酸钠治疗突发性耳聋临床疗效的Meta分析[J].医学临床研究,2019,36(10):1876-1880.
[23] 毛雪梅,刘淑云,肖茂春,等.耳后注射糖皮质激素治疗突发性聋的Meta分析[J].听力学及言语疾病杂志,2019,27(3):314-320.

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备注/Memo

备注/Memo:
*西安市卫生和计划生育委员会科技计划项目(J201603055)
更新日期/Last Update: 2020-07-28