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注射地塞米松与口服甘油联合用药与单独使用注射地塞米松治疗突发性聋的疗效比较。

Comparative Evaluation of Injection Dexamethasone and Oral Glycerol Versus Injection Dexamethasone Alone in the Treatment of Sudden Onset Sensorineural Deafness.

机构信息

Department of ENT and Head & Neck Surgery, 75119ASCOMS and Hospital, Jammu and Kashmir, India.

Dr Satish Mehta Clinic and Research Centre, Jammu and Kashmir, India.

出版信息

Ear Nose Throat J. 2021 Jun;100(3_suppl):317S-324S. doi: 10.1177/0145561320952204. Epub 2020 Sep 13.

Abstract

OBJECTIVES

Our study was aimed at finding a definitive treatment protocol for the management of sudden sensorineural hearing loss (SSNHL) and to study the prognostic factors affecting it.

METHODS

This randomized clinical study was conducted on a total of 150 patients. All patients older than 10 years and presenting within 15 days of experiencing the symptom of SSNHL and with no known etiology were included. Patients were divided into 2 groups. In group I patients, we administered systemic steroids (injection dexamethasone 3 days, followed by oral deflazacort for 6 days) with liquid glycerol; and in group II, we administered systemic steroids alone (injection dexamethasone 3 days, followed by oral deflazacort for 6 days). The total time for which the treatment was instituted was 9 days and patients were assessed on the basis of their pure tone audiogram and speech discrimination score done at days 0, 3, 7, 21, and 42.

RESULTS

There were 77 males and 73 females. Vertigo ( value < .00) and diabetes mellitus ( value < .001) had a negative prognostic influence on the recovery rate in both the groups. The comparison revealed that group I (DG) in which patients received injection dexamethasone with oral glycerol had a higher recovery rate of 86.7% as compared to group II (D) patients, in which patients received injection dexamethasone alone (recovery rate = 48%; = .000 highly significant).

CONCLUSIONS

Vertigo and diabetes mellitus play a negative role in the recovery of SSNHL. The novel treatment protocol we used in group I patients that is liquid glycerol and systemic steroids was significantly better and effective in treating SSNHL as compared to the group II treatment protocol of systemic steroids alone. Hence, we concluded that SSNHL is treatable that too with a good recovery rate.

摘要

目的

本研究旨在寻找突发性聋(SSNHL)管理的明确治疗方案,并研究影响其预后的因素。

方法

这是一项随机临床研究,共纳入 150 例患者。所有患者年龄均大于 10 岁,且在出现 SSNHL 症状后 15 天内就诊,且无明确病因。将患者分为 2 组。在 I 组患者中,我们给予全身类固醇(注射地塞米松 3 天,随后口服地夫可特 6 天)联合液体甘油治疗;在 II 组患者中,我们仅给予全身类固醇治疗(注射地塞米松 3 天,随后口服地夫可特 6 天)。治疗总时间为 9 天,根据纯音听阈和言语辨别得分,在第 0、3、7、21 和 42 天对患者进行评估。

结果

男性 77 例,女性 73 例。眩晕( value <.00)和糖尿病( value <.001)对两组患者的恢复率均有负面影响。比较发现,接受注射地塞米松联合口服甘油治疗的 I 组(DG)患者的恢复率为 86.7%,而仅接受注射地塞米松治疗的 II 组(D)患者的恢复率为 48%( recovery rate = 48%; =.000 高度显著)。

结论

眩晕和糖尿病对 SSNHL 的恢复有负面影响。与 II 组(仅全身用类固醇)相比,我们在 I 组患者中使用的新型治疗方案即液体甘油联合全身用类固醇,对 SSNHL 的治疗效果显著更好。因此,我们得出结论,SSNHL 是可治疗的,且恢复率较高。

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