鼓室内注入类固醇激素补救治疗突发性聋的文献Meta分析

摘要

目的 评价鼓室内注入类固醇激素补救治疗突发性聋的疗效及安全性.方法 通过对Cochrane图书馆、PubMed、EMbase、CBM、万方全文数据库进行计算机检索以及手工检索,对所纳入的所有应用鼓室内注入类固醇激素补救治疗突发性聋文献的随机对照试验结果(randomized controlled trials,RCTs)进行Meta分析.结果 共检索到9篇文献,425例患者(426耳)符合纳入标准.Meta分析结果显示,鼓室内注入类固醇激素补救治疗突发性聋的有效率均高于对照组[RR(95%CI)分别为10.86(4.06,29.4)、7.32(1.37,39.28)、2.10(1.00,4.37)、8.13(1.20,55.61)].有5篇文献共报道了7例该疗法的并发症,主要为注射后短暂眩晕(4例)、耳部烧灼感(1例)、耳垂部丘疹(1例)、中耳炎(1例).结论 虽然鼓室内注入类固醇激素补救治疗突发性聋的有效率有高于其他治疗方法的趋势,但由于纳入的随机对照试验质量普遍较低,因此,该疗法的疗效及安全性还需更多高质量的大样本、多中心的随机对照试验来进一步证实.%Objective To assess the effectiveness and safety of intratympanic steroid in idiopathic sudden sensorineural hearing loss as salvage treatment.Methods A thorough literature search was performed among electronic databases and by hand searching,and then evaluate the randomized controlled triats(RCTs) of intratympanic steroid in idiopathic sudden sensorineural hearing loss as salvage treatment.Results We found 9 RCTs involving 425 patients(426 ears).Meta-analysis showed a better effect of intratympanic steroid in idiopathic sudden sensorineural hearing loss as salvage treatment than the control group[RR(95％CI)were 10.86(4.06,29.4),7.32( 1.37,39.28),2.10( 1.00,4.37), 8.13 ( 1.20,55.61 )].Five literatures reported the side effects of intratympanic steroid, most of which were temporary vertigo, buring discomfort and papules on the earlobe, the incidence of secondary infection and increasing hearing loss wos low.Conclusion As quality of the most included trials was poor,we need more highquality RCTs to support the conclusion that intratympanic steroid administration after failed common treatment is safe and effective.