鼓室内注射地塞米松磷酸钠治疗突发性聋的疗效

Efficacy of Intratympanic Injection of Dexamethasone Sodium Phosphate in Sudden Deafness

目的探讨鼓室内注射地塞米松磷酸钠治疗突发性聋的临床疗效及不良反应。方法将110例患者按治疗方法的不同分为3组:治疗组(40例)、对照1组(38例)和对照2组(32例)。3组均采用舒血宁片及甲钴铵注射液治疗。在此基础上,治疗组采用鼓室内注入地塞米松磷酸钠混合液治疗,对照1组采用泼尼松治疗,对照2组采用地塞米松磷酸钠注射液治疗。观察3组临床疗效及不良反应的情况。结果治疗组总有效率明显高于对照1组和对照2组,但差异无统计学意义(80.0%比73.7%、71.9%,P>0.05)。治疗组2例出现一过性轻微疼痛,1 d后缓解,无一例在用药过程中出现明显不适、中耳感染、或鼓膜穿孔、血压升高、血糖波动、胃溃疡及性情改变等。对照1组3例出现血压升高;3例出现血糖升高,治疗后效果欠佳;2例出现失眠、烦躁,3例出现胃部不适。对照2组4例出现血压升高;3例出现血糖升高,治疗后效果欠佳;1例出现胃溃疡。结论鼓室内注射地塞米松磷酸钠混合液、静脉滴注地塞米松磷酸钠注射液及泼尼松治疗突发性聋均有效,三者之间的疗效比较无明显差异,推荐地塞米松磷酸钠作为鼓室内注射药物治疗突发性聋,并作为突发性聋的初始治疗。

Objective To investigate the clinical efficacy and adverse reactions of intratympanic injection of dexamethasone sodium phosphate in the treatment of sudden deafness. Methods A total of 110 patients were divided into three groups：treatment group （40 cases）,control group 1 （38 cases） and control group 2 （32 cases）. All patients received oral Shuxuening tablets and intramuscular injection of mecobalamin. In addition,the treatment group was given intratympanic injection of dexamethasone sodium phosphate. However,control group 1 and control group 2 were treated with prednisone and dexamethasone sodium phosphate injection, respectively.The clinical efficacy and adverse reactions were observed. Results The total effective rate in treatment group （80.0%） was higher than that in control group 1 （73.7%） or control group 2 （71.9%）, but the difference was not statistically significant （P〉 0.05）. In treatment group, 2 patients had transient slight pain,which was relieved after 1 day. No patients had obvious discomfort ,middle ear infection,tympanic membrane perforation ,blood pressure elevation, blood glucose fluctuation,gastric ulcer, disposition change,etc. In control group 1,3 patients had elevated blood pressure,3 had elevated blood glucose with poor outcome after treatment,2 had insomnia and irritability,and 3 had stomoch discomfort. In control group 2,4 patients had elevated blood pressure, 3 had elevated blood glucose with poor outcome after treatment, and 1 had gastric ulcer. Conclusion Intratympanic injection of dexamethasone sodium phosphate,intravenous injection of dexamethasone sodium phosphate or prednisone is effective for sudden deafness.There were no sign- ificant differences in curative efficacy among the three treatments.Recommend the intratympanic injection of dexamethasone sodium phosphate in the initial and subsequent treatment of sudden deafness.