卢绍坤

[摘要] 目的 探讨静脉注射前列地尔联合鼓室注射地塞米松对突发性耳聋患者听力恢复程度及血液流变学的影响，为临床治疗提供理论依据。 方法 整群收集2013年7月—2015年7月该院符合标准的突发性耳聋患者63例，按随机数字表法分为观察组32例和对照组31例，两组患者均给予常规治疗。 结果 治疗前，两组患者全血高切黏度、全血低切黏度、血浆黏度及空气传导听阈值比较，差异无统计学意义（P>0.05）。观察组患者耳鸣恢复率92.86%、眩晕恢复率84.00%，对照组耳鸣恢复率77.78%、眩晕恢复率73.91%，差异有统计学意义（P<0.05）。 结论 在常规治疗的基础上，加用静脉注射前列地尔联合鼓室注射地塞米松治疗发性耳聋能，可明显改善患者血液流变，促进听力恢复，提高治愈率和总有效率。

[Abstract] Objective To observe the effect of intravenous injection of alprostadil combined with intratympanic injection of dexamethasone on hearing improvement level and hemorheology in patients with sudden deafness and provide theoretical basis for clinical treatment. Methods 63 cases of patients with sudden deafness collected from July 2013 to July 2015 were randomly divided into the observation group with 32 cases and the control group with 31 cases， both groups were given conventional treatment， the observation group were given intravenous injection of alprostadil combined with intratympanic injection of dexamethasone on this basis， and the hemorheology indexes， change in hearing threshold value and clinical curative effect of the two groups were compared. Results The differences in the whole high blood viscosity， whole low blood viscosity， plasmic viscosity， air-conduction hearing threshold value were not statistically significant before treatment， （P>0.05）， the whole high blood viscosity， whole low blood viscosity， plasmic viscosity， air-conduction hearing threshold value after 14d of treatment were improved compared with those before treatment， but the improvement degree in the observation group was bigger than that in the control group and the difference was statistically significant（P<0.05）， after 14d of treatment， the cure rate and total effective rate were respectively 43.75% and 93.75% in the observation group and 29.03% and 74.19% in the control group， and the differences were statistically significant（P<0.05）， the recovery rate of tinnitus and vertigo was respectively 92.86% and 84.00% in the observation group and 77.78% and 73.91% in the control group， and the differences were statistically significant（P<0.05）. Conclusion Intravenous injection of alprostadil combined with intratympanic injection of dexamethasone on the basis of conventional treatment in treatment of sudden deafness can obviously improve the hemorheology， promote hearing recovery of patients and improve the cure rate and total effective rate.

[Key words] Sudden deafness； Alprostadil； Dexamethasone； Intratympanic injection； Hemorheology

突发性耳聋属感音神经性耳聋，是耳鼻喉科常见病之一，目前，激素被国内外唯一公认治疗突发性耳聋有效方法，包括局部用药（如鼓室内注射糖皮质激素）和全身使用激素治疗[1]。该研究整群选取2013年7月—2015年7月在该院符合标准的63例患者，采用静脉滴注前列地尔联合鼓室注射地塞米松治疗突发性耳聋，效果满意，现报道如下。

1 资料与方法

1.1 一般资料

入组标准：①符合突发性耳聋诊断标准[3]，单耳患病；②声导抗检测股室压力正常；③耳镜检查、听性脑干反应和MRI等检查内听道及颅脑无器质性病变；④对研究药物能耐受；⑤同意进入该研究，签订知情同意书。排除标准：①伴有蜗窗破裂；②合并中耳炎、内耳畸形、梅尼埃病、噪声性听力下降、听神经瘤等；③严重心肝肾功能障碍，影响临床用药者；④合并中枢神经系统、内分泌系统、自身免疫及出血性疾病等；⑤发病时间超过1周；⑥哺乳或妊娠期妇女。