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地塞米松鼓室内注射治疗中老年突发性耳聋的效果观察

Effect of intratympanic injection of dexamethasone in the treatment of middle-aged and elderly patients with sudden deafness

    摘要
  • 摘要:
    目的 比较地塞米松静脉滴注与鼓室内注射治疗中老年突发性耳聋(SD)的有效性与安全性。
    方法 将2018年7月—2023年11月本院收治的115例中老年SD患者随机分为A组57例与B组58例。A组予以地塞米松静脉滴注, B组予以地塞米松鼓室内注射。比较2组症状改善时间(耳鸣消失时间、呕吐消失时间、眩晕消失时间、听力恢复时间)、听力阈值(高频、低频)、睡眠质量匹兹堡睡眠质量指数量表(PSQI)、血管内皮功能一氧化氮(NO)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)、临床疗效、不良反应(一过性眩晕、轻微耳痛、皮疹)情况。
    结果 B组耳鸣消失、呕吐消失、眩晕消失、听力恢复时间均短于A组，差异有统计学意义(P < 0.05)。2组治疗后高频、低频下的听力阈值均低于同组治疗前，且B组治疗后高频、低频下的听力阈值均低于A组，差异有统计学意义(P < 0.05)。2组治疗后PSQI评分均低于同组治疗前，且B组治疗后PSQI评分低于A组，差异有统计学意义(P < 0.05)。B组治疗后NO、SOD均高于A组，LPO低于A组，差异有统计学意义(P < 0.05)。B组治疗总有效率为93.10%, 高于A组的78.95%, 差异有统计学意义(P < 0.05)。B组不良反应发生率为12.07%, A组为10.53%, 差异无统计学意义(P>0.05)。
    结论 地塞米松鼓室内注射治疗中老年SD的效果优于静脉滴注，可快速缓解患者症状，提高听力阈值，改善睡眠质量及内皮功能，不增加不良反应，有效性与安全性较高。

     

    Abstract:
    Objective To compare the efficacy and safety of intravenous infusion and intratympanic injection of dexamethasone in the treatment of sudden deafness (SD) in middle-aged and elderly patients.
    Methods A total of 115 middle-aged and elderly SD patients in the hospital from July 2018 to November 2023 were randomly divided into group A (n=57) and group B (n=58). Group A received intravenous infusion of dexamethasone, while group B received intratympanic injection of dexamethasone. The symptom improvement time (tinnitus disappearance time, vomiting disappearance time, vertigo disappearance time, and hearing recovery time), hearing thresholds (high and low frequencies), sleep qualitythe Pittsburgh Sleep Quality Index (PSQI), vascular endothelial function nitric oxide (NO), lipid peroxide (LPO) and superoxide dismutase (SOD), clinical efficacy, and adverse reactions (transient vertigo, mild ear pain, rash) were compared between the two groups.
    Results The tinnitus disappearance time, vomiting disappearance time, vertigo disappearance time, and hearing recovery time in group B were significantly shorter than those in group A (P < 0.05). The hearing thresholds at high and low frequencies after treatment in both groups were significantly lower than those before treatment, and the hearing thresholds in group B were significantly lower than those in group A after treatment (P < 0.05). The PSQI scores after treatment in both groups were significantly lower than those before treatment, and the PSQI score in group B was significantly lower than that in group A after treatment (P < 0.05). After treatment, NO and SOD in group B were significantly higher than those in group A, while LPO was significantly lower than that in group A (P < 0.05). The total effective rate in the group B was 93.10%, which was significantly higher than 78.95% in the group A (P < 0.05). The incidence of adverse reactions was 12.07% in group B and 10.53% in group A, with no significant between-group difference (P>0.05).
    Conclusion Intratympanic injection of dexamethasone is more effective than intravenous infusion in the treatment of SD in middle-aged and elderly patients, with faster symptom relief, improved hearing thresholds, better sleep quality, and endothelial function, without increasing adverse reactions, demonstrating high efficacy and safety.

     

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