联合鼓室内用药治疗糖尿病伴急性低频感音神经性听力损失

山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (8): 100-102.

联合鼓室内用药治疗糖尿病伴急性低频感音神经性听力损失

王福俊

临沂市沂水中心医院耳鼻喉科，山东临沂 276400

收稿日期:2012-05-21 出版日期:2012-08-10 发布日期:2012-08-10
作者简介:王福俊（1967- ），男，副主任医师，主要从事耳鼻喉疾病的临床研究

Transtympanic administration of dexamethasone and intravenous
administration in treatment of acute low-tone sensorineural
hearing loss complicatedwith diabetes mellitus

　WANG Fu-jun

Department of Otolaryngology, Yishui Central Hospital, Linyi 276400, Shandong, China

Received:2012-05-21 Online:2012-08-10 Published:2012-08-10

摘要/Abstract

摘要：

目的研究在全身用药基础上联合鼓室内注射地塞米松治疗糖尿病伴急性低频感音神经性听力损失(ALHL)的疗效。方法 2型胰岛素依赖型糖尿病伴ALHL患者32例（64耳）中，随机分为地塞米松鼓室注射治疗组和对照组，两组同时全身用药，治疗组在对照组用药基础上，另行鼓膜穿刺鼓室内注射地塞米松。治疗结束后1~3个月行纯音听阈（PTT）检查、声导抗测试、听性脑干反应（ABR）、耳声发射（OAE）测试。结果治疗组有效率为90.6％，优于对照组的71.9％，差异有统计学意义。治疗组治疗前后纯音听阈均值（PTA）差异有统计学意义。鼓室图均为A型，声顺值、鼓室压均正常，治疗前50耳（78.1%）能引出镫骨肌反射，治疗后58 耳（90. 6%）引出镫骨肌反射，ABR检查示，听觉神经传导径路完好，OAE 检查示内耳功能改善。鼓室内激素治疗对血糖水平无明显影响，随访1~3个月，未见鼓室内感染、鼓膜穿刺孔未愈和听力进一步下降，均无全身不良反应。结论全身用药联合鼓室内注射地塞米松治疗糖尿病伴ALHL，疗效好，操作简便，可避免全身用药可能产生的不良反应，是该疾病的首选治疗方法。

关键词: 2型糖尿病；听力丧失，感音神经性；低频；鼓室注射

Abstract:

Objective To evaluate the effects of transtympanic administration of dexamethasone and intravenous administration for patients with acute low-tone sensorineural hearing loss (ALHL)and diabetes mellitus. Methods 32 patients (64 ears) suffering from type 2 insulin dependent diabetes mellitus complicated with ALHL were randomly divided into the treatment group which was give both tympanic cavity injection of dexamethasone and intravenous administration, and the control group which was only given intravenous administration. About 1-3 months after the treatment, pure tone threshold ( PTT ) examination, tympanometry, auditory brainstem response ( ABR ) and otoacoustic emission ( OAE ) testing were required to be examined. Results Efficiency was statistically significant between the treatment group and the control group (90.6% vs 71.9%). PTA was statistically different before and after the treatment in the treatment group. Tympanometry showed type A. Compliance and tympanic pressure were normal. Stapedius reflex could be led in 50 ears (78.1%) before the treatment and in 58 ears (90.6%) after the treatment. ABR showed theauditory nerve conduction path was intact. OAE showed the inner ear function had improvements. Blood glucose levels did not significantly changed. There were no drum interior infection, tympanic membrane puncture hole condition, hearing decline, and systemic adverse reactions after a 1-3 months′ follow-up. Conclusion The above method is good in effect and simple in operation for ALHL patients with type 2 diabetes mellitus.

Key words: Type 2 diabetes mellitus; Hearing loss, sensorineural; Low-frequency; Intratympanic injection

中图分类号:

R764.4

王福俊. 联合鼓室内用药治疗糖尿病伴急性低频感音神经性听力损失[J]. 山东大学学报(医学版), 2012, 50(8): 100-102.

　WANG Fu-jun . Transtympanic administration of dexamethasone and intravenous
administration in treatment of acute low-tone sensorineural
hearing loss complicatedwith diabetes mellitus[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(8): 100-102.

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