难治性突聋耳后注射神经节苷脂联合鼓室内注射甲泼尼龙治疗前后言语识别率及影响因素分析
Comparative analysis of speech recognition ability before and after treatment of intractable sudden deafness using retroaural injection of ganglioside and intratympanic injection of methylprednisolone
曹影 1邱月 1陈智斌 2费兵 1李东 1张晓凤 3王惠 4康欣乐 5王海旭 1怀德 1李秀婷 6束明阳7
作者信息
- 1. 淮安市第二人民医院 耳鼻咽喉头颈外科,江苏 淮安 223002
- 2. 南京医科大学附属第一医院(江苏省人民医院)耳鼻咽喉头颈外科,江苏 南京 210000
- 3. 淮安市第二人民医院 药学部,江苏 淮安 223002
- 4. 淮安市第二人民医院 护理部,江苏 淮安 223002
- 5. 淮安市第二人民医院 眼科,江苏 淮安 223002
- 6. 江苏卫生健康职业学院 公共卫生管理学院,江苏 南京 210000
- 7. 淮安市第二人民医院 口腔科,江苏 淮安 223002
- 折叠
摘要
目的 分析单侧难治性突发性耳聋患者耳后注射神经节苷脂联合鼓室内注射甲泼尼龙后言语识别率(word recognition score,WRS)变化及其影响因素.方法 收集 58 例行耳后注射神经节苷脂联合鼓室内注射甲泼尼龙治疗的难治性突发性耳聋患者资料,包括患者年龄、性别、病程持续时间、耳别、伴随症状、纯音听力及言语测听等数据.对治疗前后患者患耳的纯音测听(pure tone audiometry,PTA)结果和最大言语识别率(maximum speech recognition rate,WRSmax)进行统计分析,Logistic回归分析分析影响WRS愈后的因素.结果 与治疗前比较,耳后注射神经节苷酯联合鼓室内注射甲泼尼龙治疗的患者治疗后患耳PTA和WRS有显著改善(P=0.027,P=0.038),两者呈负相关(r=-0.682,P<0.05).同时,采用单因素分析法发现年龄、性别、诱发因素、患侧耳别、伴随症状与WRS 无明显相关性,差异无统计学意义(P=0.693、P=0.208、P=0.079、P=0.335、P=0.331),而发病至首次就诊时间、听力损害程度及听力曲线类型是影响WRS疗效的重要因素(P=0.010,P=0.033,P=0.026).结论 难治性突发性耳聋患者经耳后注射神经节苷脂联合鼓室内注射甲泼尼龙治疗后WRS疗效为 41.38%,影响其疗效的因素包括:发病至首次就诊时间、听力损害程度及听力曲线类型.发病至首次就诊时间长者疗效显著差于病程短者,低频听力下降者经上述方法治疗后WRS疗效明显较平坦型及高频听力下降者好;听力损害程度越重,疗效越差.
Abstract
Objective This study aimed to analyze the impact of postauricular injection of ganglioside combined with intratympanic injection of methylprednisolone on word recognition score(WRS)and its influencing factors in patients with unilateral refractory sudden deafness.Methods This study included 58 patients with refractory sudden deafness who were treated with postauricular gan-glioside injection combined with intratympanic methylprednisolone injection.Data was collected on the patients'age,sex,disease duration,ear category,concomitant symptoms,and pure tone audiometry(PTA)and speech audiometry results pre-and post-treat-ment.The PTA results and the maximum speech recognition rate(WRSmax)were statistically analyzed pre-and post-treatment.Logistic regression analysis was applied to identify factors that improve WRS.Results Patients with refractory sudden deafness showed significant improvements in PTA and WRS in the affected ear after treatment(P=0.027,P=0.038).Furthermore,a negative correlation was observed between PTA and WRS(r=-0.682,P<0.05).Univariate analysis revealed that age,sex,precip-itating factors,affected ear,concomitant symptoms,and WRS were not significantly correlated(P=0.693,P=0.208,P=0.079,P=0.335,P=0.331)),and the differences were not statistically significant.However,time from onset to the first visit,degree of hearing damage,and type of hearing curve were identified as important factors that influenced improvement in WRS(P=0.010,P=0.033,P=0.026).Conclusion Administration of postauricular ganglioside combined with intratympanic methylprednisolone resulted in a 41.38%improvement in WRS for patients with refractory sudden deafness.Improvement in WRS was also influenced by the time from onset to the first visit,degree of hearing impairment,and type of hearing curve.The improvement in WRS was signif-icantly worse in those with a longer time from onset to first visit than in those with a shorter duration;however,it was significantly better in those with low-frequency hearing loss than in those with flat and high-frequency hearing loss after treatment with the afore-mentioned methods.The severity of hearing impairment negatively impacted improvement in WRS.
关键词
难治性突聋/鼓室内及耳后注射/言语识别率/纯音测听Key words
Refractory idiopathic sudden sensorineural hearing loss/Intratympanic and postauricular injection/Word recognition score/Pure-tone average引用本文复制引用
基金项目
江苏省卫生健康职业技术教育研究课题(WJZ202110)
江苏省卫健委科研项目(Z2019009)
江苏省高等学校基础科学(自然科学)研究面上项目(22KJB330004)
江苏卫生健康职业学院校级科研项目(JKD2021015)
出版年
2024
NETL
NSTL
万方数据