耳后骨膜下注射甲基强的松龙与静脉注射地塞米松治疗突发性耳聋的效果

Effects of retroauricular subperiosteal injection of methylprednisolone and intravenous injection of dexamethasone on sudden deafness

目的比较耳后骨膜下注射甲基强的松龙与静脉注射地塞米松治疗突发性耳聋的效果。方法选取我科2014年3月至2016年3月收治的116例突发性耳聋患者为研究对象,将其采用单盲、随机法分为Ⅰ、Ⅱ组,各58例。Ⅰ组给予地塞米松静脉注射治疗,Ⅱ组给予耳后平乳突区骨膜下甲基强的松龙注射治疗。比较两组患者的临床疗效、不同频率听力情况;比较两组糖尿病、高血压患者治疗前、后的血糖、血压水平;比较两组患者治疗期间恶心、呕吐等不良反应发生情况。结果两组患者的治疗总有效率比较,差异无统计学意义(P>0.05);治疗后7、14d,Ⅱ组患者在2000、4000、8000Hz的听力提高值显著高于Ⅰ组,差异有统计学意义(P<0.05);Ⅰ组糖尿病患者治疗后空腹血糖水平高于治疗前,高血压患者治疗后收缩压、舒张压高于治疗前(P<0.05);Ⅱ组糖尿病患者治疗前、后空腹血糖水平与高血压患者治疗前、后收缩压、舒张压比较,差异无统计学意义(P>0.05)。结论耳后骨膜下注射甲基强的松龙与静脉注射地塞米松治疗突发性耳聋均能取得理想效果,对于有消化系统溃疡病史、高血压、糖尿病的患者可优先选择耳后局部注射糖皮质激素治疗。

Objective To compare the therapeutic effects of retroauricular subperiosteal injection of methylprednisolone and intravenous injection of dexamethasone on sudden deafness. Methods A total of 116 patients with sudden deafness admitted in our department from March 2014 to March 2016 were selected as study objects and divided into group Ⅰ and group Ⅱ according to single blind and random method, with 58 cases in each group. The group Ⅰ was treated with intravenous injection of dexamethasone, and the group Ⅱ was treated with retroauricular subperiosteal injection of methylprednisolone in periosteum of posterior plain mastoid region. The clinical efficacy and hearing at different frequencies between the two groups were compared;the blood sugar and blood pressure levels before and after treatment in diabetes mellitus and hypertension patients in the two groups were compared;the incidences of nausea, vomiting and other adverse reactions during treatment between the two groups were compared. Results There was no significant difference in total effective rate of treatment between the two groups (P>0.05). At the 7, 14 day after treatment, the hearing improvement in 2 000, 4 000 and 8 000 Hz in the group Ⅱ were significantly higher than those in the group Ⅰ(P<0.05). The level of fasting blood sugar after treatment in diabetes mellitus patients of the group Ⅰ was higher than that before treatment, and the systolic and diastolic blood pressure after treatment in hypertensive patients were higher than those before treatment (P<0.05). There were no significant differences in the levels of fasting blood sugar, systolic and diastolic blood pressure before and after treatment in diabetes mellitus patients and hypertension patients of the group Ⅱ(P>0.05). Conclusion Both retroauricular subperiosteal injection of methylprednisolone and intravenous injection of dexamethasone on sudden deafness can achieve ideal effect. For patients with history of peptic ulcer, hypertension and diabetes mellitus, retroauricular local injection of glucocorticoid is preferred.