摘要：目的 研究甲强龙四种不同给药途径治疗突聋的疗效。 方法选取2012-1～2016-1运城市中心医院住院治疗的突聋患者共114例120耳，随机分为四组，A组 30耳（28 例）、B组 30耳（30例）、C组 30 耳（27 例）、D组30耳（29例），每组在基础治疗的基础上加用甲强龙，A组口服，B组静脉滴注，C组耳后骨膜下注射，D组鼓室内注射，在治疗前及治疗后一月分别行听力检查。 结果A、B、C、D组总有效率分别为53.33%、56.67%、73.33%、76.67%，各組患者听力的平均提高值分别为15.97±5.3dB，16.11±2.9dB，23.31±3.1dB，24.90±4.2 dB。C、D组总有效率及听力平均提高值与A、B组比较有统计学意义（p<0.05）。A与B、C与D组间比较无统计学意义（p>0.05）。在高频听力损失的患者中，D优于C组。结论 口服与静脉给药治疗突聋的疗效相当；局部用药优于全身用药，鼓室内注射对于高频听力损失、病史较长的患者优于耳后骨膜下注射。

关键词：甲泼尼龙琥珀酸钠；给药途径；突发性耳聋；疗效

Abstract：Objective The purpose of present study was to evaluate the efficacy of different administration of methylprednisolone in the patients of Sudden Sensorineural Hearing Loss（SSNHL）. Methods Participants were chosen who had unilateral SSNHL referred to the department of otolaryngology of Yuncheng Central Hospital between January 2012 and January 2016，114 patients（120 ears）were randomized divided into four groups were equally，group A：（30 ears/28cases）given oral methyprednisolone tablets，group B：（30 ears/30cases）received intravenous methyprednisolone injection，group C：（30 ears/27cases）received periosteum of post aur injection，group D：（30 ears/29cases）received intratympanic methyprednisolone injection. Pure tone average（PTA）was obtained at pre- and post-treatment as well as one month after. Results The general effective rate in Group A，Group B，Group C，and Group D was 53.33%，56.67%，73.33%，and 76.67%，respectively. The mean improvement hearing level were 15.97±5.3 dB，16.11±2.9 dB，23.31±3.1 dB，and 24.90±4.2 dB in group A，group B，group C，and group D，respectively. Both the general effective rate and hearing improvement gain were significantly higher in C and D than in A and B. While，there was no significant difference between A and B、C and D. During the high-frequency hearing loss patients，D higher than C. Conclusions Oral and intravenous administration in the treatment of SSNHL had similar effects. Local injection was better than systemic administration and we recommend to use ntratympanic methyprednisolone injection for the high-frequency and long history SSNHL was better than periosteum of post aur injection.

Key words：methylprednisolone；administration；Sudden Hearing Loss；efficacy

突发性耳聋是耳鼻喉科常见、多发病，近年其发病率明显上升，而且发病年龄趋于年轻化[1]。基础治疗包括改善循环、扩张血管、营养神经，但不同学者对其存在争议。目前唯一公认有效的治疗是激素[2]。选取2012-1～2016-1运城市中心医院住院治疗的突聋患者共114例120耳使用基础用药联合甲强龙不同给药途径治疗突聋患者114例120耳，取得了较满意效果，现将甲强龙不同给药途径对治疗效果的影响做一比较。

1 资料与方法

1. 1 临床资料 收集2012-1～2016-1运城市中心医院住院治疗的突发性耳聋患者共114例120耳，其中男 59例 61耳，女 55 例59 耳，年龄 15 - 71岁，平均年龄（58.6 ± 3.4）岁，病程 1 天—3月。所有患者治疗前均检查血常规及生化系列以了解患者机体状态，并行头颅及颞骨CT排除听神经瘤、脑出血、脑梗死等。……