陈翠霞　唐玉艳　周军　黄俊煊　潘珊珊　钱迪

【摘要】 目的：探讨甲强龙联合利多卡因对突发性耳聋（SSNL）鼓室注射疗效。方法：将本院耳鼻喉科2015年1月-2016年12月收治的96例SSNL随机分为研究组与对照组，每组各48例，对照组SSNL患者采用甲强龙鼓室注射治疗，研究组SSNL患者采用甲强龙联合利多卡因注射治疗，比较两组患者的疗效、不同听力曲线分型下的患者疗效，治疗前后的0.25～2.00 kHz的纯音听力测试阈值。结果：研究组的治疗效果显著优于对照组（P<0.05）;不同分型下总有效率比较，差异有统计学意义（P<0.05），有效率由高至低分别为中低频、高频、平坦、全聋型。研究组治疗第5、10、15天的0.25～2.00 kHz纯音听力阈值均显著低于对照组同期（P<0.05）。结论：中低频听力曲线分型的SSNL患者疗效显著优于平坦或全聋型，甲强龙联合利多卡因对突发性耳聋鼓室注射治疗疗效优于甲强龙鼓室治疗，可更好降低0.25～2.00 kHz的纯音听力测试阈值。

【关键词】 甲强龙; 利多卡因; 突发性耳聋; 鼓室注射; 疗效

The Efficacy of Methylprednisolone Combined with Lidocaine in the Treatment of Sudden Sensorineural Hearing Loss/CHEN Cuixia，TANG Yuyan，ZHOU Jun，et al.//Medical Innovation of China，2019，16（22）：148-153

【Abstract】 Objective：To explore the efficacy of Methylprednisolone combined with Lidocaine in the treatment of s sudden sensorineural hearing loss（SSNL）.Method：96 patients with SSNL were enrolled in our hospital from September 2015 to August 2016，they were randomly divided into study group and control group，48 cases in each group.The patients in the control group were treated with Methylprednisolone intratympanic injection.The patients in the study group were treated with Methylprednisolone combined with Lidocaine injection.The curative efficacy of SSNL between the two groups，efficacy of different hearing curve typing SSNL patients and before and after treatment of pure tone test of 0.25-2.00 kHz threshold were compared.Result：The effective rate of the study group was significantly higher than that of the control group（P<0.05）.The effective rate ranged from high to low were middle to low frequency，high frequency，flat and all deaf（P<0.05）.The hearing thresholds of pure tone of 0.25-2.00 kHz of the study group at the 5th，10th and 15th day were significantly lower than those in the control group（P<0.05）.

Conclusion：The efficacy of middle and low frequency hearing curve typing of SSNL is better than that of flat，total deafness and methylprednisolone combined with lidocaine for the treatment of SSNL in the tympanic cavity 0.25-2.00 kHz

pure tone hearing test threshold.

【Key words】 Methylprednisolone; Lidocaine; Sudden sensorineural hearing loss; Tympanic injection; Efficacy

First-authors address：Peoples Hospital of Longhua District，Shenzhen 518000，China

doi：10.3969/j.issn.1674-4985.2019.22.039

突發性耳聋（sudden sensorineural hearing loss，SSNL）是指突然发生的，可在数分钟、数小时或3 d内，原因不明的感音神经性听力缺失，甚至是相连的2个频率听力下降超过20 dB[1]。SSNL的流行病学国内暂无相关报道，2011年Stachler等[2]学者统计美国SSNL发病率为（5～20）/10万人，按照该发病率，以13亿人口计算，我国每年新增的SSNL病例为（6.5～26）万人，可见SSNL并不少见。SSNL治疗方式较多，可分为药物治疗与非药物治疗，药物治疗包含糖皮质激素、血液流变学药物、神经营养药物、溶栓抗凝药物、抗氧化药物、内淋巴减容药物、中药等;非药物治疗方案包含高压氧、星状神经节阻滞、电泳清除病理蛋白等，报道显示疗效理想[3-6]。甲强龙是治疗SSNL常见的糖皮质激素药物，文献[7-8]报道显示耳室内给药的疗效优于口服给药，利多卡因是常见的局部麻醉药，血液吸收后或静脉给药，具有明显的兴奋及抑制双相作用，小剂量给药时，可促进心肌细胞K+外流，抑制Na+通道，阻滞传入冲动，减轻或消除耳鸣症状。……