耳后注射甲强龙治疗难治性突发性聋疗效分析

Efficacy of Postauricular Methylprednisolone Injection for Refractory Sudden Hearing Loss

目的探讨耳后注射甲强龙对难治性突发性聋的治疗效果。方法 45例经全身糖皮质激素治疗后未痊愈的全部频率下降的突发性聋患者,随机分为两组:对照组(23例)仅给予降低纤维蛋白原、改善微循环及营养神经等常规治疗,耳后组(22例)在此治疗基础上给予耳后注射甲泼尼龙琥珀酸钠20mg,隔日1次,共3次。结果给药后两周:耳后组及对照组总有效率分比为50%(11/22),30.4%(7/23);显效率分别为22.7%(5/22),0。耳后组气导平均听阈提高20.01±14.11dB,对照组提高10.47±8.53dB,两组之间有显著差异(P=0.0087);耳后组低频(250Hz,500Hz)气导平均听阈提高更显著,分别提高24.09±16.95dB;25.23±18.29dB;而对照组低频(250Hz,500Hz)分别提高10.43±9.87dB;11.52±9.46dB;两组之间有显著差异(P=0.0018,P=0.0027)。结论耳后注射甲强龙治疗难治性突发性聋,疗效显著,且对低频听力提高的效果更佳。

Objective To assess the efficacy of postauricular injection of methylprednisolone in treating refractory sud-den hearing loss. Methods Forty five cases of sudden hearing loss that failed systematic glucocorticoids therapy were includ-ed in this study and divided into two groups. The Control group （n=23） was given only conventional treatment. The postauricu-lar injection group （n=22） received 3 doses of postauricular injection of methylprednisolone at 20 mg qd. in addition to con-ventional treatments. Results At 2 weeks after treatment, the rates of complete recovery and significant improvement were 50%（11/22） and 22.7%（5/22） in the postauricular injection group, and 30.4%（7/23）and 0 in the control group, respectively. Pure tone audiometry at all frequencies improved by 20.01±14.11 dB on average in the postauricular group, and 10.47±8.53 dB in the control group. The difference was statistically significant （P=0.0087）. The PTA at 250 Hz and 500 Hz improved by 24.09±16.95 dB and 25.23±18.29 dB in the postauricular injection group, and 10.43±9.87 dB and 11.52±9.46 dB in the con-trol group. The difference again was statistically significant （P=0.0018, P=0.0027）. Conclusion Postauricular methylprednis-olone injection is an effective therapy for refractory sudden hearing loss, especially for low-frequency involvement.