耳后注射甲泼尼龙琥珀酸钠联合常规药物治疗重度突发性聋

Efficacy of combined postauricular methylprednisolone injection and systemic therapy for profound Idiopathic sudden hearing loss

目的研究耳后注射甲泼尼龙琥珀酸钠（甲强龙）联合常规药物治疗重度突发性聋的临床效果及副反应,探讨耳后局部给药是否可取代传统全身激素给药方式。方法选取2014年6月-2015年5月就诊于首都医科大学附属北京安贞医院,符合研究条件的60例（61耳）突发性聋患者,均给予改善微循环及营养神经等常规治疗2周。患者随机分为两组：对照组（31耳）经静脉给予地塞米松磷酸钠注射液10 mg,每日1次,共5 d;耳后注射组（30耳）耳后注射甲强龙40 mg,每日1次,共5 d。采用SPSS 16.0软件进行统计学分析,比较治疗前后的疗效变化及副反应。结果给药后两周耳后注射组及对照组总有效率分别为76.67%和74.19%,显效率分别为36.67%,38.71%,差异无统计学意义。耳后注射组血压及血糖无明显变化。结论耳后注射甲强龙联合常规药物治疗突发性聋可获得满意疗效。耳后注射甲强龙有可能取代传统静脉激素给药用于突发性聋的治疗。

OBJECTIVE To investigate the efficacy and the related complications of combined postauricular methylprednisolone injection and systemic therapy for profound idiopathic sudden hearing loss（ISSNHL）.METHODS Total of 60 patients with ISSNHLwho had received therapy from June 2014 to May 2015 in Beijing Anzhen Hospital affiliated to Capital University of Medical Science,were randomly divided into 2groups,the systemic application group（30 patients）：dexamethasone（DEX） was applied intravenously in dose of 10 mg×5 d,and the postauricular injection group（30 patients）：methylprednisolone sodium suecinate was injected subperiosteally near the upper one-thirds of postauricular sulcus every day,40 mg×5 d.All 60 patients received the same medications for 2 weeks to improve the hearing.Hearing and tympanic membrane were monitered before the injections and two weeks after the termination of injections.SPSS 16.0 software was used to analyze the data.RESULTS The postauricular injection group：23 of 30 ears had improvement of hearing.No related complications were reported.The systemic application group：23 of 31 ears had improvement of hearing（P〉0.05） No related complications were reported.CONCLUSION Combined postauricular methylprednisolone injection and systemic medications therapy can be considered as is an effective therapy for profound idiopathic sudden hearing loss.It can avoid the side-effects of high dose systemic corticostemid treatment.For ISSNHL patients,postauricular methylprednisolone injection may be an appropriate treatment.