梁华锋　李郁明　杨田福

【摘要】 目的：探討鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗重度以上突发性耳聋的临床效果。方法：选取本院耳鼻喉科2014年10月-2017年9月收治的重度以上突发性耳聋患者48例，按照随机数字表法将其分为观察组和对照组，各24例。对照组为常规治疗（静脉注射甲强龙、前列地尔，口服甲磺酸倍他司汀、甲钴胺），观察组在对照组的基础上给予鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗，比较两组患者临床疗效、治疗前后纯音听阈值及不良反应发生情况。结果：治疗后，观察组的总有效率为83.33%，高于对照组的58.33%，差异有统计学意义（字2=4.707，P=0.030）。两组患者治疗前的纯音听阈值比较，差异无统计学意义（P>0.05）；两组患者治疗后的纯音听阈值均明显下降，且观察组患者听力改善明显优于对照组，差异均有统计学意义（P<0.05）。两组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论：鼓室注射甲强龙联合耳后骨膜下注射甲强龙治疗重度以上突发性耳聋可显著提高临床效果，患者的听力改善更显著，不良反应发生率未明显提高，值得推广。

【关键词】 突发性耳聋； 鼓室； 耳后骨膜下； 甲强龙

Effect of Tympanic Injection of Methylprednisolone Combined with Retroauricular Subperiosteal Injection of Methylprednisolone in the Treatment of Sudden Deafness/LIANG Huafeng，LI Yuming，YANG Tianfu，et al.//Medical Innovation of China，2018，15（14）：126-129

【Abstract】 Objective：To analyze the clinical effect of tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone in the treatment of severe sudden deafness.Method：A total of 48 patients with severe sudden deafness admitted from October 2014 to September 2017 in department of otolaryngology of our hospital were selected.According to the random number table method，they were divided into observation group and control group，24 cases in each group.The control group was given conventional treatment（intravenous injection of Methylprednisolone and Alprostadil，oral Betahistine Mesylate and Mecobalamin）.The observation group was given tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone treatment on the basis of the control group.The clinical effect，the threshold of pure tone audition and the incidence of adverse reactions before and after treatment were compared between the two groups.Result：After treatment，the total effective rate of clinical effect in the observation group was 83.33%，which was higher than 58.33% of the control group，the difference was statistically significant（字2=4.707，P=0.030）.There was no significant difference in the pure tone audition threshold between the two groups before treatment（P>0.05）；after treatment，the threshold of pure tone audition in the two groups were significantly decreased，the hearing improvement of the observation group was better than that of the control group，the differences were statistically significant（P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：The tympanic injection of Methylprednisolone combined with retroauricular subperiosteal injection of Methylprednisolone in the treatment of severe sudden deafness can significantly improve the clinical efficacy，the patients hearing improvement is more significant，the incidence of adverse reactions did not increase significantly，and it is worth promoting.

【Key words】 Sudden deafness； Tympanic； Retroauricular subperiosteal； Methylprednisolone

First-authors address：The Second Hospital of Shunde District in Foshan City，Foshan 528305，China

doi：10.3969/j.issn.1674-4985.2018.14.031

突发性耳聋是临床上耳鼻喉科常见的疾病，是指突然发生原因不明的感音神经性听力损失，其主要临床表现为听力下降，常伴耳鸣、眩晕、耳闷堵感等症状[1-3]。重度以上突发性耳聋是指至少在相连的两个频率听力下降71 dB以上[4]。目前国际上公认的突发性耳聋的治疗方案主要是糖皮质激素、改善循环、溶栓、营养神经等，但是重度以上的突发性耳聋患者即使采取以上所有治疗方案，预后多不良[5-6]。本……