超声引导下精准星状神经节阻滞联合三氧自体血治疗突发性聋

Precise ultrasound-guided stellate ganglion block combined with ozonated autohemotherapy in the treatment of sudden hearing loss

目的探索超声引导下精准星状神经节阻滞(UG-SGB)联合三氧自体血的综合疗法治疗突发性聋的疗效。方法选择突发性聋患者57例,男27例,女30例,年龄19~82岁,BMI 20~29 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:药物联合UG-SGB及三氧自体血治疗组(U组,n=29)和药物治疗组(D组,n=28)。U组每天行1次患侧UG-SGB和1次三氧自体血治疗,连续10 d,同时给予传统药物治疗;D组仅给予传统药物治疗。比较两组治疗前(T_(0))、出院时(T_(1))、出院后1个月(T_(2))、3个月(T_(3))、6个月(T_(4))平均听阈、听力改善情况和耳鸣恢复情况,记录局麻药中毒、气胸等不良反应发生情况。结果与T_(0)时比较,T_(1)—T_(4)时两组平均听阈明显降低(P<0.05),T_(1)—T_(4)时两组耳鸣发生率明显降低(P<0.05)。与T_(1)时比较,T_(2)—T_(4)时U组平均听阈明显降低(P<0.05)。与D组比较,U组T_(1)—T_(4)时平均听阈均明显降低(P<0.05),T_(2)—T_(4)时听力改善水平均明显升高(P<0.05),T_(2)—T_(4)时听力完全恢复比例明显升高(P<0.05),T_(3)—T_(4)时听力改善有效比例明显降低(P<0.05)。两组治疗过程中均无局麻药中毒、气胸等不良反应。结论UG-SGB联合三氧自体血配合药物治疗,能明显降低急性期突发性聋患者的平均听阈,改善患者听力水平。

Objective To investigate the efficacy of precise ultrasound-guided stellate ganglion block(UG-SGB)combined with ozonated autohemotherapy in the treatment of sudden hearing loss.Methods Fifty-seven patients with sudden hearing loss,27 males and 30 females,aged 19-82 years,BMI 20-29 kg/m^(2),ASA physical statusⅠorⅡ,were randomly divided into drugs combined with UG-SGB and ozonated autohemotherapy treatment group(group U,n=29)and drugs group(group D,n=28)according to the random number table.All patients were given drug therapy.In addition to the treatment above,patients in group U also received precise ultrasound-guided stellate ganglion block once on affected side combined with ozonated autohemotherapy once daily for 10 consecutive days.Patients in group D received drug therapy only.The average hearing threshold of the two groups was compared before treatment(T_(0)),at discharge(T_(1)),1 month(T_(2)),3 months(T_(3)),and 6 months after discharge(T_(4)).The hearing improvement of the two groups was also compared at T_(1)-T_(4) on the basis of T_(0).Moreover,tinnitus rate of the two groups was recorded T_(0)-T_(4).In addition,adverse reactions such as toxicosis of local anaesthetics,pneumothorax were recorded.Results Compared with T_(0),the average hearing threshold was reduced significantly in both groups at T_(1)-T_(4)(P<0.05),the incidence of tinnitus was reduced significantly at T_(1)-T_(4) in both groups(P<0.05).Compared with T_(1),the average hearing threshold was reduced significantly in group U at T_(2)-T_(4)(P<0.05).The average hearing threshold of group U was lower than that in group D at T_(1)-T_(4)(P<0.05).The hearing improvement in group U was better than that in group D at T_(2)-T_(4)(P<0.05).The proportion of complete hearing recovery in group U was increased significantly than that in group D at T_(2)-T_(4)(P<0.05).The proportion of effective hearing improvement in group U was decreased than that in group D at T_(3)-T_(4)(P<0.05).No obvious adverse reaction was recorded,such as toxicosis of local anaesthetics,pneumothorax.Conclusion Precise ultrasound-guided stellate ganglion block combined with ozonated autohemotherapy based on drug treatment significantly improves the average hearing threshold of patients with sudden hearing loss in acute stage and improve their hearing.