耳后注射甲泼尼龙琥珀酸钠治疗突发性耳聋的疗效及对Hcy、PLT水平的影响

Efficacy of retroauricular injection of methylprednisolone sodium succinate in the treatment of sudden deafness and the influence of Hcy and PLT levels

目的探究与分析耳后注射甲泼尼龙琥珀酸钠治疗突发性耳聋的疗效及对血清同型半胱氨酸(Hcy)及血小板(PLT)水平的影响。方法依据随机数字表法对2020年4月~2021年2月收治的突发性耳聋患者90例进行分组,每组各45例,对照组在患者耳后沟部位行乳突骨膜下注射液地塞米松磷酸钠治疗,观察组在患者耳后沟乳突骨膜下注射甲泼尼龙琥珀酸钠治疗,两组均隔1 d注射1次,两组连续治疗10 d,对比两组临床疗效、治疗前后纯音听阈值变化、血清Hcy及PLT水平,同时在治疗期间对不良反应进行观察,随访1年内耳聋复发率。结果观察组与对照组相比临床总有效率较高,差异有统计学意义(P<0.05)。观察组治疗后与对照组治疗后相比听阈值较低、PLT较低、Hcy较低,差异有统计学意义(P<0.05)。两组治疗期间不良反应相比,差异无统计学意义(P>0.05)。全部患者均接受了1年随访,观察组治疗后出现1例复发,复发率为2.22%(1/45),经对症治疗1个疗程后听力得到明显恢复,行核磁共振检查未见内听道占位的表现。对照组治疗后未出现复发。结论耳后注射甲泼尼龙琥珀酸钠治疗突发性耳聋的临床效果显著,调节改善Hcy及PLT水平,同时治疗期间未见明显不良反应,复发风险较低,综合预后表现更好。

Objective To explore and analyze the efficacy of retroauricular injection of methylprednisolone sodium succinate in the treatment of sudden deafness and the effect on serum homocysteine(Hcy)and platelet(PLT)levels.Methods According to the random number table method,90 patients with sudden deafness who were treated in our hospital from April 2020 to February 2021 were divided into groups,45 cases in each group,and the control group was treated with dexamethasone sodium phosphate injection under the mastoid periosteum in the patient’s posterior ear sulcus,and the observation group was treated with methylprednisolone sodium succinate injection under the mastoid periosteum in the patient’s posterior ear sulcus,The two groups were injected once every 1 day,and the two groups were treated for 10 days.Clinical efficacy,pure-tone hearing threshold changes before and after treatment,serum Hcy and PLT levels,adverse reactions during treatment,and the recurrence rate of deafness within 1 year of follow-up of the two groups were compared.Results Compared with the control group,the observation group had a higher total clinical effective rate,and the difference was statistically significant(P<0.05).Compared with the control group after treatment,the observation group had lower hearing threshold,lower PLT and lower Hcy,and the differences were statistically significant(P<0.05).There was no significant difference in adverse reactions between the two groups during treatment(P>0.05).All patients were followed up for 1 year.One case of recurrence occurred in the observation group after treatment,and the recurrence rate was 2.22%(1/45).After one course of symptomatic treatment,the hearing was obviously recovered,and no space occupying performance of the internal auditory canal was found by MRI.No recurrence occurred in the control group after treatment.Conclusion Retroauricular injection of methylprednisolone sodium succinate has a significant clinical effect in the treatment of sudden deafness,regulate and improve the levels of Hcy and PLT.At the same time,there was no obvious adverse reaction during the treatment,and the risk of recurrence was low,the overall prognosis is better.