耳后注射与全身应用糖皮质激素治疗突发性聋的疗效对比分析

The curative effect analysis between postauricular injection and systemic application of glucocorticoids in the treatment of sudden hearing loss

目的：对比分析耳后注射甲泼尼龙琥珀酸钠与全身静脉应用地塞米松治疗突发性聋的疗效。方法选取58例单侧突发性聋患者，按随机单盲法随机分为两组，全身激素治疗组：地塞米松磷酸钠注射液10 mg 静脉注射，每天1次，连用3 d 后，减量至5 mg 静脉注射，每天1次，连用4 d 后停药；局部注射治疗组：在患侧耳后平外耳道口上缘水平乳突区骨膜下局部注射甲泼尼龙琥珀酸钠40 mg，每3天1次，连用5次或至听力恢复正常即停止。结果全身激素治疗组总有效率67．7％，耳后注射治疗组总有效率70．4％，差异无统计学意义（χ2＝2．58，P ＝0．316）。两组全部频率平均听阈的改善差异无统计学意义（t ＝2．71，P ＝0．062），低频率（250 Hz，500 Hz）平均听阈的改善耳后注射治疗组均明显高于全身激素治疗组（t ＝3．82，P ＝0．031；t ＝3.26，P ＝0．042）。结论全身应用和耳后局部注射糖皮质激素治疗突发性聋均有较好疗效，常规治疗建议首选全身激素治疗，对低频突发性聋耳后局部注射可作为优先治疗选择。

Objective To investigate the therapeutic effect of topical corticosteroids injection and systemic application in the treatment of sudden hearing loss.Methods Total of 58 patients with sudden hearing loss were ran-domly divided into two groups.The systemic application group：dexamethasone （DEX）was applied by intravenous injection in dose of 10mg ×3d,followed by 5mg ×4d.And the postauricular injection group：methylprednisolone sodium succinate of 40mg was injected into cortical bone of mastoid region every three days,until hearing back to normal,or 15 days.SPSS 13.0 software was used to analyze the data.Results The total effective rate of systemic application group was 67.7%,the total effective rate of postauricular injection group was 64.7%.There was no statistical differ-ence between the two groups （χ2 =2.58,P =0.316）.The recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group,but no statistical difference between the two groups（t =2.71,P =0.062）.Patients with hearing loss in low frequencies（250Hz,500Hz）,the recovery rate in cases with postauricular injection group was significantly increased in comparison with the systemic application group （t =3.82,P =0.031;t =3.26,P =0.042）.Conclusion Postauricular topical injection and systemic application of glucocorticoids in the treatment of sudden hearing loss are all have good curative effect.Systemic application is select-ed by conventional treatment,and topical injection has a better effect in the hearing loss of low -middle frequencies.