鼓室内注射地塞米松治疗全聋型突发性聋伴糖尿病的疗效分析

Therapeutic Effect of Intratympanic Injection of Dexamethasone in the Treatment of Sudden Total Sensorineural Hearing Loss with Diabetes Mellitus

目的探讨鼓室内注射地塞米松治疗全聋型突发性聋伴糖尿病的治疗效果。方法选取2015年9月—2018年9月间南京医科大学附属南京医院诊治的47例全聋型突发性聋伴糖尿病患者,按照治疗方案分为观察组25例与对照组22例,观察组的治疗方案为鼓室内注射地塞米松5 mg,隔日一次,连用5次,治疗组的治疗方案为地塞米松10 mg静脉滴注,连用3 d,3 d后减量为5 mg,使用4 d后停药。观察组和对照组的患者其余基础治疗药物相同,密切监测血糖。结果鼓室内注射地塞米松的观察组患者听力改善的总有效率达到60.00%,而对照组的总有效率为59.09%,观察组与对照组差异比较无明显统计学意义(χ2=0.004,P=0.949)。结论鼓室内注射地塞米松局部用药与静脉滴注地塞米松全身性用药治疗全聋型突发性聋伴糖尿病的疗效相当,且鼓室注射地塞米松局部用药对糖尿病患者的血糖控制未产生不良影响,安全有效,值得临床推广。

Objective To explore the therapeutic effect of intratympanic injection of dexamethasone in the treatment of sudden to?tal sensorineural hearing loss(SSNHL)with diabetes.Methods 47 patients with sudden deafness of diabetes mellitus who were diag?nosed and treated in the hospital from September,2015 to September,2018 were divided into observation group and control group ac?cording to the treatment plan.The treatment plan of the observation group received intratympanic injection with dexamethasone 5 mg,once every other day,for 5 times.The treatment group received dexamethasone 10 mg intravenous infusion for 3 days.After 3 days,the amount reduced to 5 mg,and the drug was discontinued after 4 days.The remaining basic therapeutic drugs were observed in the same group as the control group,and blood glucose was closely monitored.Results The total effective rate of hearing improvement in the observation group of intratympanic injection of dexamethasone reached 60.00%,while the total effective rate of the control group was 59.09%.There was no significant difference between the observation group and the control group(χ2=0.004,P=0.949).Conclu?sion The intratympanic injection of dexamethasone topical medication and intravenous infusion of dexamethasone systemic therapy for the treatment of sudden total sensorineural hearing loss with diabetes mellitus has equivalent effect,and the intratympanic injection of dexamethasone topical medication has no adverse effect on glycemic control in diabetic patients.It is safe and effective,and worthy of clinical promotion.