Li L L, Huang L L, Miu S J, Zhang H
Department of Otolaryngology, Suzhou Kowloon Hospital, School of Medicine, Shanghai Jiaotong University, Suzhou, 215000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Apr;32(7):533-536. doi: 10.13201/j.issn.1001-1781.2018.07.014.
To investigate the clinical effect of local combined with systemic glucocorticoid injection on young and middle-aged patients with severe and profound hearing loss. Ninety-three cases of young and middle-aged patients with severe and profound hearing loss admitted to our hospital from May 2013 to May 2017 were retrospectively analyzed. Patients were divided into two groups according to the different treatment. Forty-six cases in control group were treated with systemic injection of glucocorticoids.Forty-seven cases in observation group were treated with local administration combined with systemic glucocorticoid therapy. The efficacy, changes of average hearing threshold and the incidence of adverse reactions were evaluated.The total effective rate in the observation group was 68.09%, which was significantly higher than that in the control group (45.65%,<0.05).After treatment, the average hearing thresholds in the observation groups of 0.5,1.0,2.0 and 4.0kHz were(35.77±13.28)dB HL,(39.71±14.09)dB HL, (32.99±10.73)dB HL and (30.17±9.29)dB HL respectively,which were significantly higher than that in the control group(26.30±14.03)dB HL,(25.14±13.28)dB HL,(20.54±9.27)dB HL,and (20.98±8.71)dB HL(<0.05).Among all the patients received systemic injection of dexamethasone sodium phosphate injection,there was no other complications were found except for one patient whose blood pressure instability was relieved after treatment stopping. In the observation group, intratympanic methylprednisolone sodium succinate did not cause serious complications such as tympanic cavity infection and perforation of the tympanic membrane on the basis of systemic injection.While in the observation group,one case complained of earache and one case complained of a slight burning sensation in the ear, and both of them eased after rest.Local combined with systemic glucocorticoid treatment of young and middle-aged patients with severe and profound hearing loss can significantly improve the efficiency and increase the average hearing threshold changes at 0.5,1.0,2.0 and 4.0 kHz,and there was no serious adverse reactions.
探讨局部联合全身糖皮质激素注射治疗中青年重度及极重度听力损失患者的临床效果。回顾性分析2013年5月至2017年5月我院收治的93例中青年重度及极重度听力损失患者。根据治疗方法不同将患者分为两组。对照组46例采用全身注射糖皮质激素治疗。观察组47例采用局部给药联合全身糖皮质激素治疗。评估疗效、平均听阈变化及不良反应发生率。观察组总有效率为68.09%，显著高于对照组（45.65%，P<0.05）。治疗后，观察组0.5、1.0、2.0及4.0kHz的平均听阈分别为（35.77±13.28）dB HL、（39.71±14.09）dB HL、（32.99±10.73）dB HL及（30.17±9.29）dB HL，均显著高于对照组（26.30±14.03）dB HL、（25.14±13.28）dB HL、（20.54±9.27）dB HL及（20.98±8.71）dB HL（P<0.05）。在所有接受地塞米松磷酸钠注射液全身注射的患者中，除1例患者治疗停药后血压不稳定缓解外，未发现其他并发症。在观察组中，鼓膜内注射甲泼尼龙琥珀酸钠在全身注射的基础上未引起鼓室感染、鼓膜穿孔等严重并发症。而在观察组中，1例患者诉耳痛，1例患者诉耳部有轻微烧灼感，休息后均缓解。局部联合全身糖皮质激素治疗中青年重度及极重度听力损失患者可显著提高疗效，并增加0.5、1.0、2.0及4.0kHz的平均听阈变化，且无严重不良反应。
