易虹

[摘要] 目的 探讨采用耳后注射甲强龙对全聋型突发性聋的临床疗效分析。 方法 选择2015年1月～2016年1月期间在我院就诊的42例全聋型突发性聋患者，按照随机原则分为两组，两组患者均采用改善微循环、营养神经等常规治疗，其中对照组中再行非耳后注射地塞米松治疗，而观察组患者则是行耳后注射甲强龙治疗，对比两组患者在治疗两周后的临床疗效，各频段听力提高值。 结果 观察组的听力疗效情况相比于对照组改善程度更明显，差异有统计学意义（P<0.05）。对照组患者治疗后在125 ～ 250Hz、125 ～ 500Hz、500 ～ 2000Hz、4000 ～ 8000Hz以及250～4000Hz这5个频段上听力提高值均不及观察组，并且125 ～ 250Hz、125 ～ 500Hz这两个频段和观察组比较差异有统计学意义（P<0.05）。 结论 对于全聋型突发性耳聋的患者，可以在营养神经、改善微循环等常规治疗的基础上给予耳后注射液甲强龙，可以有效提高治疗效果，显著提高125 ～ 250Hz、125～500Hz这两个频段的听力情况，值得临床推广。

[关键词] 耳后；甲强龙；全聋型；突发性聋

[中图分类号] R764.437 [文献标识码] A [文章编号] 2095-0616（2017）08-21-04

[Abstract] Objective To investigate the clinical effect analysis of injecting methylprednisolone into the posterior ear in the treatment of sudden hearing loss of total deafness type. Methods 42 cases of patients with sudden hearing loss of total deafness type cured in our hospital from January 2015 to January 2016 were selected and were randomly divided into two groups.All the patients were treated with conventional treatments，such as，improving microcirculation and trophic nerve，etc.Among them，the patients in control group were injected with dexamethasone into the posterior ear，and patients in observation group were injected with methylprednisolone.The clinical effects and improvement values at different frequency bands after two weeks of treatment were compared. Results Compared with the control group， the observation group had a better effect on hearing，and the difference was statistically significant （P<0.05）.After treatment，in terms of hearing improvement values at five frequency bands of 125-250Hz，125-500Hz，500-2000Hz，4000-8000Hz and 250-4000Hz，the patients in control group were not better than those of observation group，and the differences with observation group in terms of two frequency bands of 125-250Hz，125-500Hz were statistically significant （P<0.05）. Conclusion For patients with sudden hearing loss of total deafness type，the injection of methylprednisolone treatment at post aurem on the basis of the conventional treatments，such as，trophic nerve and improving microcirculation，etc.can effectively improve the treatment effect，and improve the hearing at two frequency bands of 125-250Hz and 125-500Hz.It is worthy of clinical promotion.

[Key words] Post aurem；Methylprednisolone；Total deafness；Sudden hearing loss

突發性聋是临床常见的耳鼻喉科病种之一，目前尚不完全清楚突发性聋的具体发病机制，主流的假说包括血循环障碍、免疫介导作用以及病毒感染所致。抛开发病机制而言，临床采用激素、免疫抑制等治疗手段被证明是真实有效的，因此已经成为一线治疗方案[1-2]。而其中激素的治疗包括局部和全身给药两种方式，考虑到存在血迷路屏障，因此全身激素给药的情况下进入到内耳的实际激素剂量有限，一定程度影响了治疗效果[3]。而局部的激素治疗可有效避免这个缺点，将激素及时送达至内耳发挥抗炎作用。本文对耳后、非耳后注射甲强龙各自疗效进行研究，现将2015年1月～2016年1月期间在我院就诊的42例全聋型突发性聋患者相关资料整理总结，现报道如下。

1 资料与方法

1.1 一般资料

选择2015年1月～2016年1月期间在我院就诊的42例全聋型突发性聋患者。……