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[摘要]
目的 探討耳內(nèi)窺鏡下鼓室內(nèi)注射甲強龍對伴眩暈突聾患者聽力康復(fù)及前庭功能和凝血功能的影響。方法 以2014年3月至2017年6月銅川市人民醫(yī)院收治的62例伴眩暈突聾患者為研究對象。根據(jù)治療方案不同將所有患者分為對照組和觀察組各31例。所有患者均給予改善內(nèi)耳微循環(huán)、降低血黏度和抗凝等常規(guī)治療。對照組在常規(guī)治療基礎(chǔ)上采取甲強龍靜脈注射治療。觀察組在常規(guī)治療基礎(chǔ)上給予耳內(nèi)鏡下鼓室注射甲強龍治療,均治療10 d。分析對比兩組的治療總有效率和治療前后的凝血功能和前庭功能情況,采用血漿凝固法對凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、凝血酶時間(TT)和纖維蛋白原(FIB)進(jìn)行測定。結(jié)果 觀察組的治療總有效率為77.42%,高于對照組的54.84%,差異有統(tǒng)計學(xué)意義(P<0.05)。耳內(nèi)窺鏡下鼓室內(nèi)注射甲強龍對前庭功能正?;颊叩闹委熆傆行?7.78%,高于對前庭功能異?;颊叩闹委熆傆行?8.46%(P<0.05)。治療前,兩組之間的前庭功能情況差異均無統(tǒng)計學(xué)意義;對照組治療后的前庭功能情況差異無統(tǒng)計學(xué)意義;觀察組治療后的前庭功能正常占比高于治療前,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療前,兩組的PT、APTT、TT和FIB水平不具有統(tǒng)計學(xué)差異;治療后,兩組治療后的PT、APTT和TT水平高于且FIB水平低于治療前,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);觀察組的PT、APTT和TT水平高于且FIB水平低于對照組,差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 耳內(nèi)窺鏡下鼓室內(nèi)注射甲強龍治療伴眩暈突聾,有利于患者聽力康復(fù),能一定程度上改善前庭功能和凝血功能,但該研究的不足之處在于樣本量較少,需要擴大樣本量做進(jìn)一步研究。
[Key word]
[Abstract]
Objective To discuss the effects of methylprednisolone indoor injection under endoscope on hearing recovery,vestibular function and blood coagulation function of sudden deafness patients with vertigo. Methods A total of 62 sudden deafness patients with vertigo treated in our hospital from March 2014 to June 2017 were selected as research objects and were divided into control group (31 cases) and observation group (31 cases). And the patients were also divided into normal vestibular function group (38 cases) and abnormal vestibular function group (23 cases) according to frequency-eye seismogram (VNG) inspection. The total efficiency, vestibular function and blood coagulation function of two groups were compared. And the total efficiency of different vestibular function patients treated with methylprednisolone indoor injection under endoscope were compared. Results The total efficiency of observation group was higher than control group (P < 0.05). The total efficiency of normal vestibular function group treated with methylprednisolone indoor injection under endoscope was higher than abnormal vestibular function group (P < 0.05). The difference in vestibular function of two groups was no statistically significant (P < 0.05). The difference in vestibular function of control group before and after treatment showed no no statistically significant (P < 0.05). The normal vestibular function proportion of observation group after treatment was higher than that before treatment (P < 0.05). Before treatment, prothrombin time (PT),activation of partial thrombin time (APTT), thrombin time (TT) and fibrinogen (FIB) of two groups were not statistically significant. After treatment, PT, APTT and TT levels of observation group were higher and FIB level was lower than those of the control group (P < 0.05). The PT, APTT and TT levels of observation group after treatment were higher and FIB level was lower than those before treatment (P < 0.05). Conclusion The sudden deafness patients with vertigo treated with methylprednisolone indoor injection under endoscope contributes to the hearing recovery, improve vestibular function and coagulation function. However, the deficiency of this research is that the sample size is relatively small, so it is necessary to expand the sample size for further study.
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