鼓室注射甲强龙补救治疗全聋型突聋的临床分析

Clinical analysis of intratympanic methylprednisolone injection as salvage treatment for total sudden deafness after initial treatment failure

目的探讨鼓室注射甲强龙补救治疗全聋型突聋的疗效。方法 55例经初始系统治疗2周无效的全聋型突聋患者纳入研究,均为单耳发病。按数字随机法分为实验组(鼓室注射甲强龙+口服甲钴胺)和对照组(口服甲钴胺),其中实验组26例,对照组29例,两组行相对应治疗结束后4周复查纯音听力阈值。结果实验组纯音听力阈平均值为(59.88±9.54)d B,对照组为(67.62±7.63)d B,两者差异具有统计学意义(t=3.338,P=0.002),实验组听力改善(18.08±10.06)d B,高于对照组的(11.48±6.34)d B(t=2.869,P=0.006)。结论常规系统治疗无效的全聋型突聋患者采用鼓室内注射甲强龙,可以明显改善听力,提高疗效,值得推荐。

Objective To investigate the therapeutic effect of intratympanic methylprednisolone injection for total sudden deafness after initial treatment failure as salvage treatment. Methods 55 patients with diagnosis of total sudden deafness, who failed in responding to a two-week course of initial treatment, were divided into experimental group （ intratympanic methylprednisolone injection plus oral administration of mecobalamine, n = 26 ） and control group （ oral administration of mecobalamine, n = 29）. Pure-tone threshold audiometry was performed within 4 weeks after the salvage treatment. Results The average pure-tone threshold （APT） and APT improvement of the experimental group were 59.88 ± 9.54 dB and 18.08 ± 10.06 dB respectively, while those of the control group were 67.62 ± 7.63 dB and 11.48 ± 6.34 dB. Both differences of APT and APT improvement between the two groups were statistically significant （ both P 〈 0.05 ）. The obvious effective and total effective rates of the experimental group were 30.77% （8/26） and 46.15 % （ 12/26 ） , and those of the control group were 6.89% （2/29） and 10.34% （3/29）. The differences of the obvious effective and total effective rates between the two groups were also statistically significant （ both P 〈 0. 05 ）. Conclusion Intratympanie methylprednisolone injection is beneficial as salvage treatment for total sudden deafness failed in responding to initial treatment.