摘要
目的观察甲泼尼龙琥珀酸钠鼓室途径给药治疗系统疗法无效的突发性聋患者的疗效，探索突聋预后影响因素。方法经全身系统治疗无效的突聋患者42例，采用鼓膜穿刺法注入40mg／ml甲泼尼龙琥珀酸钠0．3-0．5ml，隔日1次，连续应用3-7次。比较鼓室注射前后0．5-4kHz气导纯音听阈均值差异，分析相关因素对预后的影响。结果鼓室内注射疗法治疗前后，全组病例气导平均听阂分别为（66．48±17．03）dBHL和（49．9±20．93）dBHL，治疗前后平均听阈差异明显（P〈0．01）；其中19例有效，总有效率为45．2％。听力损失程度、伴有眩晕与否及发病后鼓室注射疗法开始时间等因素对预后影响明显。结论甲泼尼龙琥珀酸钠鼓室注射疗法治疗突聋安全有效，可以作为经全身系统治疗无效突聋患者的后续治疗选择。一般治疗无效者，应尽早采用本疗法。
Objective To observe the therapeutic effect of intratympanic injection therapy with methylprednisolone on the ineffective cases of sudden sensorineural heating loss treated by systematic general therapies. Methods Included in this study were 42 intractable cases of sudden sensofineural heating loss treated by systematic common therapies and retreated by an intratympanic injection therapy with 40 mg/ml methylprednisolone at a dosage of 0.3 - 0.5 ml, once per another day and 3 - 7 times in total for these cases. A comparative analysis was made on the differences in the averaged air conduction heating threshold （ACHT） tested by pure tone audiometry from 0.5 - 4 kHz before and after this therapy. Meanwhile, explored also were the effect of associated pathogenic factors on the prognosis of these cases. Results The averaged ACHT was 66.48±17.03 dB HL before the intratympanic injection therapy and that was 49.94±20.93 dB HL after this therapy, with a statistically significant difference between them （P〈0.01） and with 19 cases being effective out of them resulted in a total effective rate of 45.2%. The factors holding the significant implications in their prognosis included such ones as level of hearing loss, companied vertigo and the intratympanic injection therapy if begun as earlier as possible. Conclusions It is safe and effective to use the intratympanic injection therapy with methylprednisolone for the treatment of intractable cases with sudden hearing loss following the treatment of systematic general therapies and this kind of therapy can be taken as a possible choice of the following-up treating treaties for such patients. Once the common therapies show no significantly therapeutic effects on patients with such a condition, such therapy as recommended here should be tried in a most possibly earlier stage.
出处
《中国中西医结合耳鼻咽喉科杂志》
2009年第2期83-86,共4页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
关键词
突发性聋
鼓室注射疗法
甲泼尼龙琥珀酸钠
疗效
Sudden hearing loss
Intratympanic injection therapy
Methylprednisolone
Therapeutic effect
