地塞米松鼓室内注射治疗中老年突发性耳聋的效果观察

Effect of intratympanic injection of dexamethasone in the treatment of middle-aged and elderly patients with sudden deafness

目的比较地塞米松静脉滴注与鼓室内注射治疗中老年突发性耳聋(SD)的有效性与安全性。方法将2018年7月—2023年11月本院收治的115例中老年SD患者随机分为A组57例与B组58例。A组予以地塞米松静脉滴注,B组予以地塞米松鼓室内注射。比较2组症状改善时间(耳鸣消失时间、呕吐消失时间、眩晕消失时间、听力恢复时间)、听力阈值(高频、低频)、睡眠质量[匹兹堡睡眠质量指数量表(PSQI)]、血管内皮功能[一氧化氮(NO)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)]、临床疗效、不良反应(一过性眩晕、轻微耳痛、皮疹)情况。结果B组耳鸣消失、呕吐消失、眩晕消失、听力恢复时间均短于A组,差异有统计学意义(P<0.05)。2组治疗后高频、低频下的听力阈值均低于同组治疗前,且B组治疗后高频、低频下的听力阈值均低于A组,差异有统计学意义(P<0.05)。2组治疗后PSQI评分均低于同组治疗前,且B组治疗后PSQI评分低于A组,差异有统计学意义(P<0.05)。B组治疗后NO、SOD均高于A组,LPO低于A组,差异有统计学意义(P<0.05)。B组治疗总有效率为93.10%,高于A组的78.95%,差异有统计学意义(P<0.05)。B组不良反应发生率为12.07%,A组为10.53%,差异无统计学意义(P>0.05)。结论地塞米松鼓室内注射治疗中老年SD的效果优于静脉滴注,可快速缓解患者症状,提高听力阈值,改善睡眠质量及内皮功能,不增加不良反应,有效性与安全性较高。

Objective To compare the efficacy and safety of intravenous infusion and intratympanic injection of dexamethasone in the treatment of sudden deafness(SD)in middle-aged and elderly patients.Methods A total of 115 middle-aged and elderly SD patients in the hospital from July 2018 to November 2023 were randomly divided into group A(n=57)and group B(n=58).Group A received intravenous infusion of dexamethasone,while group B received intratympanic injection of dexamethasone.The symptom improvement time(tinnitus disappearance time,vomiting disappearance time,vertigo disappearance time,and hearing recovery time),hearing thresholds(high and low frequencies),sleep quality[the Pittsburgh Sleep Quality Index(PSQI)],vascular endothelial function[nitric oxide(NO),lipid peroxide(LPO)and superoxide dismutase(SOD)],clinical efficacy,and adverse reactions(transient vertigo,mild ear pain,rash)were compared between the two groups.Results The tinnitus disappearance time,vomiting disappearance time,vertigo disappearance time,and hearing recovery time in group B were significantly shorter than those in group A(P<0.05).The hearing thresholds at high and low frequencies after treatment in both groups were significantly lower than those before treatment,and the hearing thresholds in group B were significantly lower than those in group A after treatment(P<0.05).The PSQI scores after treatment in both groups were significantly lower than those before treatment,and the PSQI score in group B was significantly lower than that in group A after treatment(P<0.05).After treatment,NO and SOD in group B were significantly higher than those in group A,while LPO was significantly lower than that in group A(P<0.05).The total effective rate in the group B was 93.10%,which was significantly higher than 78.95%in the group A(P<0.05).The incidence of adverse reactions was 12.07%in group B and 10.53%in group A,with no significant between-group difference(P>0.05).Conclusion Intratympanic injection of dexamethasone is more effective than intravenous infusion in the treatment of SD in middle-aged and elderly patients,with faster symptom relief,improved hearing thresholds,better sleep quality,and endothelial function,without increasing adverse reactions,demonstrating high efficacy and safety.