中华耳科学杂志2017，Vol.15Issue(6)：709-714,6.DOI:10.3969/j.issn.1672-2922.2017.06.020
不同局部应用糖皮质激素方式在治疗难治性突发性聋的疗效观察
Rescue Glucocorticoid Treatments for Refractory Sudden Sensorineural Hearing Loss
摘要
Abstract
Objective To report outcomes of various rescue glucocorticoid treatment regimens for refractory sud-den sensorineural hearing loss(SSNHL).Methods Three hundred and five cases(305 ears)of SSNHL that had failed more than 10 days of conventional therapy were divided into a study group(SG,277 ears)and a comparison group(CG,28 ears).Patients in the SG received glucocorticoids via a micro-catheter inserted into the tympanum qd for 10 consecu-tive days plus i.v.transfusion of gingko extracts and monosialotetrahexosylganglioside(group A,206 ears),4 doses of postaural injection of glucocorticoids every 3 days plus i.v.transfusion of gingko extracts and monosialotetrahexosylgan-glioside(group B,42 ears)or 4 does of postaural injection of glucocorticoids every three days plus oral (group C,19 ears).Patients in the CG received only i.v.transfusion of gingko extracts and monosialotetrahexosylganglioside.All pa-tients in both SG and CG were maintained on oral gingko extracts and vitamin B12 following rescue therapy and fol-lowed up for 3 months.Results The effective rate in the SG was significantly higher than in the CG (χ2=14.11,P=0.003).The average PTA improvement was 11.63⊥16.75 dB (Group A),17.78⊥18.12 dB (Group B) and 18.38⊥22.9dB(Group C)respectively for the SG,but only 4.85 dB for the CG(t=2.75,P=0.043).When treatment was started within 3 weeks post-disease onset,effective rates showed no statistically significant difference between intratympanic and postaural injection of glucocorticoids (P>0.05).Conclusion The rescue glucocorticoids injection treatments em-ployed in the SG in this study appear to be beneficial as compared to no rescue treatments.While the interval from dis-ease onset to therapy can affected treatment efficacy,when started within 3 weeks from disease onset,intratympanic glu-cocorticoid perfusion appears to be similarly effective as postauricular glucocorticoids injection only.关键词
鼓室灌注/突发性聋/难治性/耳后注射/糖皮质激素Key words
Intratympanic Perfusion/Sudden Sensorineural Hearing Loss/Refractory/Postauricular Injection/Glucocorticoid分类
医药卫生引用本文复制引用
高子雯,戴艳红,后婕,齐慧,朱文燕,佘万东..不同局部应用糖皮质激素方式在治疗难治性突发性聋的疗效观察[J].中华耳科学杂志,2017,15(6):709-714,6.基金项目
本研究得到国家自然科学基金项目(81271074,81670931)、江苏省临床医学科技专项(BL2014002)、江苏省第十批"六大人才高峰"项目(WSN-009)、南京市医学科学技术发展项目(YKK13054)资助.江苏省科教强卫工程江苏省医学重点学科资助,项目编号ZDXKB2016015Natural Science Foundation of China(81271047,81670931) （81271074,81670931）
Special clinical medical science and technology in Jiangsu (BL2014002) （BL2014002）
Tenth batch of"top six talent peaks"in Jiangsu(WSN-009) （WSN-009）
Nanjing medical science and technology development proj-ect(YKK13054) （YKK13054）
The Project of Invigorating Health Care through Science,Technology and Education,Jiangsu Provincial Medical Dis-cipline(ZDXKB2016015)； （ZDXKB2016015）
