鼓室注射神经节苷脂钠联合耳后注射甲泼尼龙治疗难治性突发性聋的临床观察

Efficacy of Intratympanic Injection of Monosialotetrahexosylganglioside Sodium Combined with Postauricular Injection of Methylprednisolone in the Treatment of Refractory Sudden Deafness

目的本研究旨在比较鼓室注射神经节苷脂联合耳后注射甲泼尼龙,与单独耳后注射甲泼尼龙治疗重度及以上难治性突发性聋的疗效。方法选择符合突聋诊断标准、发病10天以上、常规治疗无效的重度及以上的突聋患者(PTA,0.5-4 kHz,>60 dB HL)78例,随机分为试验组和对照组,试验组给予神经节苷脂鼓室注射联合甲泼尼龙耳后注射,对照组仅给予甲泼尼龙耳后注射,治疗结束后观察15天,复测PTA,前瞻性观察鼓室注射神经节苷脂联合耳后注射甲泼尼龙治疗难治性突发性聋的疗效。结果试验组有效率为53.85%,PTA平均改善值为21.97 dB HL,对照组有效率为30.77%,PTA平均改善值12.07 dB HL,两组的疗效存在统计学差异(P=0.039,P=0.019)。结论鼓室注射单唾液酸四己糖神经节苷脂钠联合耳后注射甲泼尼龙,比单纯耳后注射甲泼尼龙治疗重度及以上难治性突发性聋的疗效更佳。

Objective To report the efficacy of intratympanic injection of ganglioside combined with postauricular injection of methylprednisolone in the treatment of severe refractory sudden deafness.Methods Seventy-eight patients with refractory sudden deafness(PTA across 0.5-4 kHz>60 dB HL)of less than 10 days were randomly assigned to a study(intratympanic injection of Monosialotetrahexosylganglioside sodium combined with postauricular injection of methylprednisolone)or a control(postauricular injection of methylprednisolone only)group.The PTA was retested fifteen days after treatment.Results The rate of hearing improvement was 53.85%in the study group(average improvement of PTA=21.97 dB)and 30.77%in the control group(average improvement of PTA=12.07 dB).Conclusion Intratympanic injection of Monosialotetrahexosylganglioside sodium combined with postauricular injection of methylprednisolone is more effective than postauricular injection of methylprednisolone alone in the treatment of severe refractory sudden deafness.