大剂量地塞米松治疗全聋型和平坦型突发性聋临床效果观察

The effect observation of high dose dexamethasone in treatment of full type and flat type sudden sputum

目的观察大剂量地塞米松治疗全聋型和平坦型突发性聋的疗效。方法回顾性分析2010年1月-2014年12月于该院接受治疗的全聋型(26例)和平坦型(15例)突发性耳聋患者的临床资料,所有患者均给予大剂量地塞米松等药物治疗。对比观察2组临床疗效和听力恢复效果。结果平坦型组痊愈率显著高于全聋型组(P<0.05),平坦型愈显率为53.3%,总有效率为80.0%;全聋型愈显率为65.4%,总有效率为80.8%,但2组愈显率与总有效率比较,差异无统计学意义(P>0.05)。平坦型患者听力恢复效果从第3天起逐渐增加(P<0.05),全聋型患者第6天听力恢复效果高于第3天(P<0.05),但第6、9、12、15天听力恢复效果无明显差异(P>0.05)。结论大剂量地塞米松治疗全聋型和平坦型突发性聋的总有效率无差异,全聋型患者痊愈率很低。大部分患者在治疗3~6 d内听力提高,超过此天数听力提高的几率降低,应考虑在原有治疗方案基础上积极行其他挽救性治疗措施。

Objective To observe the clinical effect of high dose dexamethasone in treatment of full type and flat type sudden sputum. Methods Retrospective analysis the clinical dates of full sputum type（ 26 cases） and flat type（ 15 cases）sudden deafness from January 2010 to December 2014 in the hospital. All patients were treated by high dose dexamethasone.After treatment,compared the clinical efficacy and hearing recovery effect of 2 groups. Results The recovery rate of flat type was higher than that of full-size group（ P〈0. 05）. The recovery and demonstrated efficiency of flat type was 53. 3%,The total efficiency of flat type was 80. 0%,The recovery and demonstrated efficiency of full type was 65. 4%,The total efficiency of full type was 80. 8%. The increasing rate and total efficiency of 2 groups was no statistic significant（ P〉0. 05）. The hearing recovery effect of flat type patients gradually increased from the third day（ P〈0. 05）,The hearing recovery effect of the full type patients on the 6 th day was higher than that on the 3 rd day（ P〈0. 05）. However,there was no significant difference in hearing recovery between the 6 th,9 th,12 th and 15 th days（ P〉0. 05）. Conclusion The total efficiency of high dose dexamethasone in treatment of full type and flat type sudden sputum was no statistic significant. The recovery and demonstrate efficiency of full type is low. In most patients,hearing recovery increased within 3 to 6 days after treatment,and hearing recovery amplitude gradually decreased afterwards. Other salvage treatments should be considered on the basis of the original treatment plan.