返回 
加入收藏
耳后与鼓室内注射地塞米松治疗全频下降型突发性聋的疗效与安全性比较
x
请在关注微信后，向客服人员索取文件
| 篇名： | 耳后与鼓室内注射地塞米松治疗全频下降型突发性聋的疗效与安全性比较 |
| TITLE： | Comparison of the efficacy and safety of postauricular and intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss with all frequency loss |
| 摘要： | 目的 对比分析耳后与鼓室内注射地塞米松联合常规治疗方案治疗全频下降型突发性聋的临床疗效与安全性。方法回顾性选取2020年6月1日至2025年5月31日于浙江中医药大学附属中西医结合医院就诊的全频下降型突发性聋患者150例为研究对象，按照其地塞米松的不同注射方式分为鼓室组（鼓室内注射，n＝78）与耳后组（耳后注射，n＝72）。对比两组患者治疗前后听阈指标及听力疗效、耳鸣/眩晕指标、治疗前后凝血功能指标，以及治疗期间不良反应的差异。结果治疗后，两组患者的平均言语听阈及平均听阈均较治疗前显著下降（P＜0.05），但组间比较差异无统计学意义（P＞0.05）。两组中不同听力损失程度患者的疗效均存在差异（鼓室组P＝0.005，耳后组P＜0.001），且听力损失程度与疗效等级均呈显著线性趋势关系（P＜0.001），表现为听力损失越重，疗效越差；其中鼓室组在重度和极重度听力损失患者中的疗效优于耳后组（P＜0.05）。在治疗前合并眩晕患者中，耳后组的有效率显著高于鼓室组（P＜0.05），而合并耳鸣患者中的两组差异无统计学意义（P＞0.05）。两组患者的纤维蛋白原（FIB）、活化部分凝血活酶时间均较治疗前显著降低或缩短（P＜0.05），凝血酶时间（TT）、凝血酶原时间均较治疗前显著延长（P＜0.05），且耳后组患者的FIB显著低于鼓室组、TT显著长于鼓室组（P＜0.05）。两组患者的消化道反应、出血征象、肝肾功能异常、过敏反应等不良反应发生率比较，差异均无统计学意义（P＞0.05），但鼓室组患者的前庭症状发生率显著高于耳后组（P＜0.05）。结论与鼓室内注射比较，耳后注射地塞米松联合常规治疗方案治疗全频下降型突发性聋在总体听力改善方面疗效相当，但后者在改善眩晕症状、提升不同听力损失程度患者应答、调节凝血功能和减少前庭不良反应方面存在一定优势，而前者可能更适合听力损失程度较重的患者。 |
| ABSTRACT： | OBJECTIVE To compare and analyze the clinical efficacy and safety of postauricular versus intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss （SSNHL） with all frequency loss. METHODS A retrospective study was conducted on 150 patients with SSNHL with all frequency loss who were treated at the Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang University of Chinese Medicine between June 1， 2020， and May 31， 2025. According to different injection routes， the patients were divided into the intratympanic group （intratympanic injection， n ＝78） and the postauricular group （postauricular injection， n ＝72）. The differences in hearing threshold indicators and auditory outcomes before and after treatment， tinnitus/vertigo indicators， coagulation function indicators before and after treatment， as well as adverse reactions during treatment were compared between the two groups. RESULTS After treatment， both groups demonstrated significant reductions in the mean speech-frequency threshold and the mean hearing threshold compared with baseline （ P ＜0.05）， whereas no statistically significant differences were observed between the two groups （ P ＞0.05）. Therapeutic outcomes varied significantly across different degrees of hearing loss in each group （intratympanic group： P ＝0.005； postauricular group： P ＜0.001）. Moreover， a significant linear trend relationship was observed between the degree of hearing loss and treatment efficacy grades （ P ＜0.001）， indicating that the more severe the hearing loss， the poorer the treatment outcome （ P ＜0.05）. Notably， the intratympanic group demonstrated superior efficacy compared with the postauricular group in patients with severe and profound hearing loss （ P ＜0.05）. Among patients presenting with vertigo prior to treatment， the postauricular group exhibited a significantly higher response rate than the intratympanic group （ P ＜0.05）， while no statistically significant difference was observed between the two groups in patients with tinnitus （ P ＞0.05）. Regarding coagulation parameters， fibrinogen （FIB） levels and activated partial thromboplastin time decreased or shortened significantly follo wing therapy （ P ＜0.05）， whereas thrombin time （TT） and prothrombin time were significantly prolonged （ P ＜0.05）. Moreover， the postauricular group showed lower FIB levels and longer TT values compared with the intratympanic group （ P ＜0.05）. No significant differences were identified between the two groups in the incidence of gastrointestinal reactions， bleeding manifestations， hepatic or renal dysfunction， or allergic reactions （ P ＞0.05）； however， vestibular adverse reactions occurred more frequently in the intratympanic group （ P ＜0.05）. CONCLUSIONS Compared with intratympanic injection， postauricular dexamethasone injection combined with conventional treatment regimens achieved comparable efficacy in overall hearing improvement in SSNHL patients with all frequency loss. However， the postauricular injection shows potential advantages in vertigo relief， enhancing treatment response in patients with varying degrees of hearing loss， regulating of coagulation function， and declucing of vestibular adverse reactions， while the intratympanic injection may be more suitable for patients with severe hearing loss. |
| 期刊： | 2026年第37卷第05期 |
| 作者： | 潘惠娣；宝庆付；王昌阳 |
| AUTHORS： | PAN Huidi，BAO Qingfu，WANG Changyang |
| 关键字： | 全频下降型突发性聋；地塞米松；耳后注射；鼓室内注射；疗效；安全性 |
| KEYWORDS： | sudden sensorineural hearing loss with all frequency loss； dexamethasone； postauricular injection； intratympanic |
| 阅读数： | 2 次 |
| 本月下载数： | 0 次 |
* 注：未经本站明确许可，任何网站不得非法盗链资源下载连接及抄袭本站原创内容资源!在此感谢您的支持与合作！
