鼓室内注射地塞米松治疗突发性耳聋的临床观察

Clinical study on intratympanic dexamethasone injection in treatment of sudden sensorineural hearing loss

目的 分析鼓室内注射地塞米松对经常规治疗无效突发性耳聋的治疗效果.方法 选择44例经常规治疗无效的突发性耳聋患者,按机械抽样法随机分为鼓室内注射组24例和对照组20例,对照组给予常规治疗,鼓室内注射组在耳显微镜下往鼓膜内缓慢注入地塞米松2.5 mg.结果 鼓室内注射组总有效率（37.5%,9/24）明显高于对照组（10.0%,2/20）,差异有统计学意义（P〈0.05）.鼓室内注射组纯音听阈治疗后[（52.75±20.14）dB]较治疗前[（70.26±20.76）dB]明显改善（P〈0.05）,同时也优于对照组治疗后[（63.55±19.36）dB]（P〈0.05）.结论 鼓室内注射地塞米松可作为常规治疗无效的突发性耳聋患者的挽救治疗手段,亦可作为避免全身大剂量使用激素不良反应的常规治疗手段之一.

Objective To observe the clinical efficacy of intratympanic dexamethasone injection for patients with sudden sensorineural hearing loss （SSNHL）. Methods Forty-four SSNHL cases （44 ears） which failed to respond to regular treatments were divided into two groups. The intratympanic injection group （24 eases） were injected dexamethasone 2.5 mg to the tympanic cavity every two days,4 times in all. The control group （20 eases） were treated with B1,B12 and triphosaden. Pure tone average （PTA） was tested before and 3 days after treatment. Results The total effective rate of intratympanic injection group was higher than that of control group [37.5%（9/24） vs 10.0%（2/20）] （P 〈 0.05）. In intratympanic injection group, PTA of post-injection was significantly lower than the pre-injection[ （52.75±20.14） dB vs （70.26±20.76） dB ] （P 〈 0.05）. PTA of post-injection in intratympanic injection group was significantly better than that in control group[（52.75±20.14） dB vs （63.55±19.36） dB]（P〈 0.05）. Conclusion Intratympanic dexamethasone injection can be applied to SSNHL patients who failed to respond to systemic corticosteroid treatment and it can avoid the side effects brought on by high dose systemic corticosteroid treatment.