目的：探讨耳后注射甲强龙对难治性突发性聋的治疗效果。方法45例经全身糖皮质激素治疗后未痊愈的全部频率下降的突发性聋患者，随机分为两组：对照组(23例)仅给予降低纤维蛋白原、改善微循环及营养神经等常规治疗，耳后组（22例）在此治疗基础上给予耳后注射甲泼尼龙琥珀酸钠20mg，隔日1次，共3次。结果给药后两周：耳后组及对照组总有效率分比为50%（11/22），30.4%(7/23)；显效率分别为22.7%（5/22），0。耳后组气导平均听阈提高20.01±14.11dB，对照组提高10.47±8.53dB，两组之间有显著差异（P=0.0087）；耳后组低频（250Hz，500Hz）气导平均听阈提高更显著，分别提高24.09±16.95dB；25.23±18.29dB；而对照组低频（250Hz，500Hz）分别提高10.43±9.87dB；11.52±9.46dB；两组之间有显著差异（P=0.0018，P=0.0027）。结论耳后注射甲强龙治疗难治性突发性聋，疗效显著，且对低频听力提高的效果更佳。%Objective To assess the efficacy of postauricular injection of methylprednisolone in treating refractory sud-den hearing loss. Methods Forty five cases of sudden hearing loss that failed systematic glucocorticoids therapy were includ-ed in this study and divided into two groups. The Control group (n=23) was given only conventional treatment. The postauricu-lar injection group (n=22) received 3 doses of postauricular injection of methylprednisolone at 20 mg qd. in addition to con-ventional treatments. Results At 2 weeks after treatment, the rates of complete recovery and significant improvement were 50%(11/22) and 22.7%(5/22) in the postauricular injection group, and 30.4%(7/23)and 0 in the control group, respectively. Pure tone audiometry at all frequencies improved by 20.01±14.11 dB on average in the postauricular group, and 10.47±8.53 dB in the control group. The difference was statistically significant (P=0.0087). The PTA at 250 Hz and 500 Hz improved by 24.09±16.95 dB and 25.23±18.29 dB in the postauricular injection group, and 10.43±9.87 dB and 11.52±9.46 dB in the con-trol group. The difference again was statistically significant (P=0.0018, P=0.0027). Conclusion Postauricular methylprednis-olone injection is an effective therapy for refractory sudden hearing loss, especially for low-frequency involvement.
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