背景:突发性感音神经性听力损失(SSNHL),以快速和无法解释的听力丧失为特征,特别是在中高频,提出了重大的临床挑战。甲基强的松龙琥珀酸钠(MPSS)通过不同的给药途径的治疗用途,与常规药物结合,仍然是一个感兴趣的话题。
目的:比较MPSS不同给药途径联合常规药物治疗中高频SSNHL的疗效。
方法:对109例中高频SSNHL患者的病历进行分析。根据给药途径将患者分为三组:A组[鼓室内(IT)注射MPSS联合甲钴胺和银杏叶提取物注射液],B组(静脉注射MPSS联合甲钴胺和银杏叶提取物注射液),和C组(单次IT注射MPSS)。对干预效果进行对比分析。
结果:A组治疗后听阈(21.23±3.34)明显低于B组(28.52±3.36)和C组(30.23±4.21;P<0.05)。A组的语音识别率(92.23±5.34)明显高于B组和C组。听力恢复的时间,A组眩晕消失时间明显短于B、C组(P<0.05)。A组总有效率(97.56%)明显高于B组和C组(77.14%和78.79%,χ2=7.898,P=0.019)。此外,A组和C组的不良反应发生率明显低于B组(4.88%,3.03%vs2.57%,χ2=11.443,P=0.003),A组复发率明显低于B、C组(2.44%vs20.00%vs21.21%,χ2=7.120,P=0.028)。
结论:IT注射MPSS联合常规治疗与静脉输注全身给药和单次IT注射MPSS相比,具有更好的疗效和安全性。这种方法有效地改善了患者的听力,降低了疾病复发的风险。
BACKGROUND: Sudden sensorineural hearing loss (SSNHL), characterized by a rapid and unexplained loss of hearing, particularly at moderate to high frequencies, presents a significant clinical challenge. The therapeutic use of methylprednisolone sodium succinate (MPSS) via different administration routes, in combination with conventional medications, remains a topic of interest.
OBJECTIVE: To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid- to high-frequency SSNHL.
METHODS: The medical records of 109 patients with mid- to high-frequency SSNHL were analyzed. The patients were divided into three groups based on the route of administration: Group A [intratympanic (IT) injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection], Group B (intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection), and Group C (single IT injection of MPSS). The intervention effects were compared and analyzed.
RESULTS: The posttreatment auditory thresholds in Group A (21.23 ± 3 .34) were significantly lower than those in Groups B (28.52 ± 3.36) and C (30.23 ± 4.21; P < 0.05). Group A also exhibited a significantly greater speech recognition rate (92.23 ± 5.34) than Groups B and C. The disappearance time of tinnitus, time to hearing recovery, and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C (P < 0.05). The total effective rate in Group A (97.56%) was significantly greater than that in Groups B and C (77.14% and 78.79%, χ 2 = 7.898, P = 0.019). Moreover, the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B (4.88%, 3.03% vs 2.57%, χ 2 = 11.443, P = 0.003), and the recurrence rate in Group A was significantly lower than that in Groups B and C (2.44% vs 20.00% vs 21.21%, χ 2 = 7.120, P = 0.028).
CONCLUSIONS: IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS. This approach effectively improves patients\' hearing and reduces the risk of disease recurrence.