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目的:观察鼓室内灌注地塞米松治疗难治性突发性聋(SD)的疗效。方法:对全身应用激素治疗无效及伴高血压、糖尿病的34例SD患者行鼓室内灌注地塞米松治疗,观察听力、耳鸣及耳闷症状的恢复情况,并对年龄、性别及病程等可能对疗效造成影响的因素进行统计学分析和比较。结果:①治疗后总体听力、耳鸣及耳闷的有效率分别为52.9%、58.8%和82.4%。病程<2周者的听力及耳鸣的治疗有效率优于病程≥2周者,但组间差异均无统计学意义(均P>0.05)。②经全身激素治疗无效患者听力恢复有效率为44.4%;伴高血压、糖尿病患者听力恢复有效率为62.5%。结论:鼓室内灌注地塞米松治疗难治性SD疗效肯定且无明显全身不良反应,为全身应用激素禁忌的SD患者提供了一个有效的治疗途径,并可作为口服激素治疗无效患者的补救治疗方法。
Objective: To observe the curative effect of intrathecal dexamethasone in treatment of refractory sudden deafness (SD). Methods: Thirty-four SD patients with systemic steroid therapy and hypertension and diabetes mellitus were treated with intratympanic infusion of dexamethasone. The recovery of hearing, tinnitus and ear bothersome symptoms was observed. The effects of age, gender, course of disease and so on Factors affecting the efficacy of statistical analysis and comparison. Results: ① After treatment, the overall hearing, tinnitus and stuffy ears were 52.9%, 58.8% and 82.4%, respectively. Duration of <2 weeks of hearing and tinnitus treatment is better than the effective duration of ≥ 2 weeks, but no significant difference between groups (P> 0.05). (2) The effective rate of hearing recovery was 44.4% in patients who were not treated by systemic hormone therapy. The effective rate of hearing recovery was 62.5% in patients with hypertension and diabetes. CONCLUSION: Intra-tympanosolic dexamethasone is effective in the treatment of refractory SD and has no obvious systemic adverse reactions. It provides an effective treatment for SD patients with systemic contraindication of hormones and can be taken as remedial treatment for patients with oral steroid ineffective .