本文選題：突發(fā)性聾 + 糖皮質(zhì)激素　； 參考：《遵義醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察耳后注射糖皮質(zhì)激素治療全頻下降型突發(fā)性聾的療效,探討耳后注射糖皮質(zhì)激素在突發(fā)性聾的臨床應(yīng)用。方法:采用前瞻性對(duì)照研究,從2015年7月至2016年6月在深圳市龍崗區(qū)耳鼻咽喉醫(yī)院收治的突發(fā)性聾病例中,選取符合納入標(biāo)準(zhǔn)的全頻下降型患者,按照入院順序簡(jiǎn)單隨機(jī)分為兩組。66例患者納入研究,其中男40例,女26例,左耳37例,右耳29例,年齡18-60歲,平均39歲,發(fā)病到開始治療時(shí)間為1-14天,平均6天。耳后給藥組(35例)給予耳后注射甲強(qiáng)龍,40 mg/d,連續(xù)5天;靜脈給藥組(31例)給予靜脈滴注甲強(qiáng)龍,40 mg/d,連續(xù)5天;其他治療方法兩組相同。10天后比較兩組療效差異。應(yīng)用SPSS 18.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)聽力損失:(1)總體比較:耳后給藥組和靜脈給藥組的治療有效率分別為71.42%(25/35)和77.41%(24/31),兩組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。耳后給藥組和靜脈給藥組治療后的平均聽閾分別為55.10±26.92 dB HL和41.12±23.56 dB HL,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)單因素比較:將患者依次列入相同的聽力損失程度組、年齡組、病程組和伴隨癥狀組做平均聽閾比較。結(jié)果顯示:除了伴有眩暈癥狀組外,其他各因素組靜脈給藥對(duì)平均聽閾的改善均優(yōu)于耳后給藥,其中聽力損失程度為重度極重度組、病程為≤7天組,兩種方法比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)耳鳴癥狀:90.91%(60/66)的患者有耳鳴,耳后給藥組31例,靜脈給藥組29例,治療有效率分別為77.41%(24/31)和75.86%(22/29),兩組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(3)眩暈癥狀:18.18%(12/66)的患者有眩暈,其中6例前庭功能正常,6例前庭功能異常,2例前庭功能異常合并有BPPV。靜脈給藥組6例,耳后給藥組6例,均在治療10天內(nèi)眩暈癥狀得到控制。結(jié)論:(1)耳后注射糖皮質(zhì)激素做為全頻下降型突發(fā)性聾的初始治療,對(duì)聽力損失治療有效,但聽力提高幅度不如靜脈給藥明顯;可改善耳鳴癥狀,但無(wú)明顯作用優(yōu)勢(shì);控制眩暈效果不明顯。(2)對(duì)于無(wú)糖皮質(zhì)激素全身給藥禁忌癥的全頻下降型突發(fā)性聾患者,建議初始治療仍選擇靜脈給藥,尤其是聽力損失程度為重度極重度聾或病程為≤7天的患者。
[Abstract]:Objective: to observe the effect of retroauricular glucocorticoid injection in the treatment of fully-frequency descending sudden deafness and to explore the clinical application of retroauricular glucocorticoid injection in sudden deafness. Methods: from July 2015 to June 2016 in Shenzhen Longgang District Otolaryngology Hospital, the patients with sudden deafness were selected from a prospective controlled study. According to the order of admission, the patients were randomly divided into two groups: 40 males, 26 females, 37 left ears, 29 right ears, aged 18-60 years, with an average age of 39 years. The mean time from onset to treatment was 1-14 days, with an average of 6 days. 35 patients in the retroauricular administration group were given 40 mg / d intraauricular injection of ketenolone 40 mg / d for 5 days, and 31 cases in the intravenous administration group were given 40 mg / d intravenous drip of 40 mg / d of ketoprolol for 5 days. The difference of curative effect between the two groups after 10 days was the same as that in the other two groups. SPSS 18.0 software was used for statistical analysis. Results the overall effective rates of retroauricular administration group and intravenous administration group were 71.42 / 35) and 77.41% / 31 respectively. There was no significant difference between the two groups (P 0.05). The average hearing threshold after treatment was 55.10 鹵26.92 dB HL and 41.12 鹵23.56 dB HL in the retroauricular group and intravenous group, respectively. The difference was statistically significant (P 0.05): the patients were divided into the same hearing loss group and age group in turn, and the average hearing threshold after treatment was 55.10 鹵26.92 dB HL and 41.12 鹵23.56 dB HL, respectively. The mean hearing threshold was compared between the course group and the concomitant symptom group. The results showed that the improvement of the average hearing threshold was better in the other factors group than in the retroauricular group except the group with vertigo symptoms. The degree of hearing loss was severe and the course of the disease was 鈮，

本文編號(hào)：1929874