前列地尔联合鼓室注射地塞米松治疗突发性耳聋临床疗效及对血液流变学影响.docVIP

前列地尔联合鼓室注射地塞米松治疗突发性耳聋临床疗效及对血液流变学影响 　　[摘要] 目的 探?前列地尔联合鼓室注射地塞米松治疗突发性耳聋的临床疗效及对血液流变学的影响。 方法 选取2016年1～11月我院收治的88例突发性耳聋患者，将其按照随机数字法随机分为观察组和对照组，每组44例，两组均给予常规治疗，对照组在常规治疗基础上给予前列地尔进行治疗，观察组在常规治疗基础上给予前列地尔联合鼓室注射地塞米松进行治疗，观察比较两组治疗前后纯音听阈（pure tone audiometry，PTA）的变化，检测比较治疗前后血液流变学指标（全血高切黏度、全血低切黏度、血浆黏度），并对治疗前后两组的临床疗效及安全性进行评价。 结果 治疗后两组PTA均显著下降（t=2.874、6.695，P均0.05），但观察组下降更为明显（t=3.981，P0.05）。治疗后两组全血高切黏度、全血低切黏度、血浆黏度均显著下降（P0.05），但观察组下降更为明显（t=18.511、17.823、8.145，P均0.05）。治疗后观察组总有效率高于对照组。两组治疗期间均未出现眩晕、短暂性眩晕等不良反应。 结论 前列地尔联合鼓室注射地塞米松治疗突发性耳聋临床疗效显著，安全性高，可促进患者听力恢复，并改善患者血液流变学指标，值得临床推广。 　　[关键词] 前列地尔；鼓室注射；地塞米松；突发性耳聋；血液流变学 　　[中图分类号] R764.43+7 [文献标识码] B [文章编号] 1673-9701（2017）06-0078-04 　　[Abstract] Objective To investigate the clinical efficacy of alprostadil combined with intratympanic injection of dexamethasone in the treatment ofsensorineural hearing loss and its effect on hemorheology. Methods A total of 88 patients with sensorineural hearing loss who were admitted to our hospital from January to November 2016 were selected. The patients were randomly divided into the observation group and the control group according to random number method， with 44 patients in each group. Both groups were given routine therapy. The control group was given alprostadil on the basis of routine therapy. The observation group was given alprostadil combined with intratympanic injection of dexamethasone on the basis of the routine therapy. The changes of pure tone audiometry（PTA） before and after treatment were compared between the two groups. Indices of hemorheology before and after the treatment（whole blood high shear viscosity， low shear viscosity， plasma viscosity） were detected and compared. The clinical efficacy and safety of the two groups before and after treatment were evaluated. Results After the treatment， PTA was decreased significantly in both groups（t= 2.874， 6.695， P 　　激素冲击作为治疗突发性耳聋的传统首选药物，具有强大抗炎、抗免疫反??的作用；内耳血液流变中，内皮素的作用非常重要；内耳内皮细胞分泌的内皮素可收缩血管、升高血压，而地塞米松可直接抑制内皮素的合成。可快速有效减轻内耳水肿，改善内耳微循环及毛细胞功能，能减轻神经水肿，改善