甲泼尼龙琥珀酸钠乳突骨膜下注射治疗突发性耳聋的临床疗效观察

Clinical efficacy of mastoid subperiosteal injection with methylprednisolone on sudden deafness

目的观察甲泼尼龙琥珀酸钠耳后沟乳突骨膜下注射治疗突发性耳聋的临床疗效。方法将78例突发性耳聋患者随机分为观察组和对照组,每组39例。两组均给予甲钴胺注射液、维生素B1注射液肌肉注射及银杏叶提取物静脉滴注常规治疗,观察组在常规治疗的基础上用甲泼尼龙琥珀酸钠于耳后沟行乳突骨膜下注射,对照组用地塞米松磷酸钠注射液在耳后沟行乳突骨膜下注射。比较两组患者临床疗效、治疗前后纯音听阈值、血常规指标、血清内皮素(ET)、一氧化氮(NO)、同型半胱氨酸(Hcy)水平以及不良反应发生情况。结果观察组总有效率为92.3%,对照组为74.4%,观察组疗效优于对照组(P<0.05)。治疗后观察组的纯音听阈值、PLT计数、血清ET、Hcy水平均低于对照组,NO水平高于对照组(P<0.05),而两组WBC、RBC计数及不良反应发生率比较,差异均无统计学意义(P>0.05)。结论在常规治疗的基础上采用甲泼尼龙琥珀酸钠行乳突骨膜下注射治疗突发性耳聋疗效确切,可有效改善听力,安全可靠。

Objective To observe the clinical efficacy of mastoid subperiosteal injection with methylprednisolone on sudden deafness.Methods Seventy-eight patients with sudden deafness were randomly divided into observation group and control group,with 39 cases in each group. Both groups were treated with mecobalamin injection,vitamin B1 injection and intravenous drip of Ginkgo biloba extract,and on the basis of the conventional therapy above,the observation group was given mastoid subperiosteal injection with methylprednisolone at retroauricular groove,while the control group with dexamethasone sodium phosphate. The clinical efficacy,pure tone threshold,indices of complete blood test,levels of serum endothelin（ ET）,nitric oxide（ NO） and homocysteine（ Hcy） before and after treatment,and incidence of adverse reactions were compared between the two groups. Results The total effective rates of the observation group and the control group were 92. 3% and 74. 4%,respectively,and the efficacy of the observation group was better than that of the control group（ P〈0. 05）. After treatment,the pure tone threshold,PLT count and the levels of serum ET and Hcy were lower,but the level of NO was higher in the observation group compared to the control group（ P〈0. 05）,and there was no significant difference in the WBC count,RBC count or incidence rate of adverse reactions between the two groups（ P〈0. 05）. Conclusion The mastoid subperiosteal injection with methylprednisolone based on the conventional therapy has definite effects on sudden deafness,which can effectively improve the hearing,and it is safe and reliable.