CAJ | 학술논문

目的：探讨脱水剂和鼓室内注射皮质类固醇激素对急性低频感音神经性听力损失的疗效。方法选取153例（153耳）急性低频感音神经性听力损失患者作为研究对象，根据耳蜗电图和速尿试验的检查结果将所有患者分为2组，耳蜗电图及速尿试验均正常的A组76例（耳）与耳蜗电图异常和/或速尿试验异常的B组77例（耳），每组患者随机分别应用3种治疗方法，一种是单独应用鼓室内注射皮质类固醇激素（激素组），一种是单独应用脱水剂（脱水组），第三种是鼓室内注射激素联合应用脱水剂（联合组），2周后观察疗效，并随访半年。结果A组三组之间听力恢复的有效率、治愈率、耳鸣改善有效率及症状改善起始天数比较均有统计学意义，其中，激素组（A）和脱水组（A）、脱水组（A）和联合组（A）之间比较亦有统计学意义，激素组（A）和联合组（A）比较无统计学意义；B组三组之间有效率、治愈率、耳鸣改善有效率及症状改善起始天数比较均有统计学意义，其中，脱水组（B）和联合组（B）、激素组（B）和联合组（B）比较亦有统计学意义，激素组（B）和脱水组（B）比较无统计学意义；复发率在A组三组之间、B组三组之间的比较均无统计学意义。结论鼓室内注射皮质类固醇激素治疗急性低频感音神经性听力损失疗效确切、副作用小，然后，需根据耳蜗电图和速尿试验的检查结果，决定是否加用脱水剂，以获取更佳的治疗效果。
목적：탐토탈수제화고실내주사피질류고순격소대급성저빈감음신경성은력손실적료효。방법선취153례（153이）급성저빈감음신경성은력손실환자작위연구대상，근거이와전도화속뇨시험적검사결과장소유환자분위2조，이와전도급속뇨시험균정상적A조76례（이）여이와전도이상화/혹속뇨시험이상적B조77례（이），매조환자수궤분별응용3충치료방법，일충시단독응용고실내주사피질류고순격소（격소조），일충시단독응용탈수제（탈수조），제삼충시고실내주사격소연합응용탈수제（연합조），2주후관찰료효，병수방반년。결과A조삼조지간은력회복적유효솔、치유솔、이명개선유효솔급증상개선기시천수비교균유통계학의의，기중，격소조（A）화탈수조（A）、탈수조（A）화연합조（A）지간비교역유통계학의의，격소조（A）화연합조（A）비교무통계학의의；B조삼조지간유효솔、치유솔、이명개선유효솔급증상개선기시천수비교균유통계학의의，기중，탈수조（B）화연합조（B）、격소조（B）화연합조（B）비교역유통계학의의，격소조（B）화탈수조（B）비교무통계학의의；복발솔재A조삼조지간、B조삼조지간적비교균무통계학의의。결론고실내주사피질류고순격소치료급성저빈감음신경성은력손실료효학절、부작용소，연후，수근거이와전도화속뇨시험적검사결과，결정시부가용탈수제，이획취경가적치료효과。
To investigate the effectiveness of diuretics and intratympanic steroids in treating patients with acute low-tone sensorineu-ral hearing loss (ALHL). Methods We retrospectively reviewed medical records of 153 patients with a diagnosis of ALHL. The patients were divided into two groups based upon electrocochleogram (ECochG) and furosemide test results:group A (normal on both tests, n=76)and group B (abnormal on either ECochG and/or furosemide test, n=77). Patients in each group were ran-domly selected to receive one of the following three therapes:intratympanic steroids alone (the steroid group), diuretic treat-ment alone (the diuretic group) and steroid/diuretic combination treatment (the combination group). All patients were treated for 14 days and followed up for 6 months. Results The differences in the rates of complete hearing recovery, hearing improve-ment, tinnitus improvement and time to improvement were statistically significant among different therapies for both groups A and B. Within Group A, the differences were statistically significant between the steroid and diuretic groups and between the combination and diuretic groups, but not between the steroid and combination groups;whereas within Group B, the differences were statistically significant between the combination and steroid groups and between the combination and diuretic groups, but not between the steroid and diuretic groups. The recurrence rate was not significantly different among all groups. Conclusion Our results indicate that intratympanic steroid is effective in ALHL with minimal side effects. Addition of a diuretic can be de-termined based upon ECochG and furosemide test results to augment treatment effectiveness.