中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
5期
412-416
,共5页
丁秀勇%崔婷婷%冯国栋%高志强
丁秀勇%崔婷婷%馮國棟%高誌彊
정수용%최정정%풍국동%고지강
听觉丧失,突发性%糖皮质激素类%投药途径%Meta分析
聽覺喪失,突髮性%糖皮質激素類%投藥途徑%Meta分析
은각상실,돌발성%당피질격소류%투약도경%Meta분석
Hearing loss,sudden%Glucocorticoids%Drug administration routes%Meta-analysis
目的 系统评价比较鼓室内和全身应用糖皮质激素对于突发性聋初始治疗的有效性和安全性.方法 用国际Cochrane协作网方法,检索鼓室内和全身糖皮质激素用于突发性聋初始治疗的随机对照试验,对符合入选标准的文献提取资料进行Meta分析.结果 突发性聋不伴糖尿病患者鼓室内应用糖皮质激素的有效率与全身应用的有效率相比较,组间差异无统计学意义(RR=1.11,95％ CI=0.96 ～ 1.28,P=0.15),治愈率差异有临界性统计学意义(RR=1.30,95％ CI=0.99～1.71,P=0.05)；突发性聋合并糖尿病患者鼓室内应用糖皮质激素的有效率高于全身应用的有效率(RR =1.24,95％ CI=1.02～1.50,P=0.03).全身应用糖皮质激素的主要并发症为血糖升高,鼓室内给药的并发症包括疼痛、一过性眩晕、中耳感染、永久性鼓膜穿孔等.结论 对于突发性聋合并糖尿病的患者初始治疗优先考虑鼓室内应用糖皮质激素,不伴糖尿病者仍首选全身应用糖皮质激素.
目的 繫統評價比較鼓室內和全身應用糖皮質激素對于突髮性聾初始治療的有效性和安全性.方法 用國際Cochrane協作網方法,檢索鼓室內和全身糖皮質激素用于突髮性聾初始治療的隨機對照試驗,對符閤入選標準的文獻提取資料進行Meta分析.結果 突髮性聾不伴糖尿病患者鼓室內應用糖皮質激素的有效率與全身應用的有效率相比較,組間差異無統計學意義(RR=1.11,95％ CI=0.96 ～ 1.28,P=0.15),治愈率差異有臨界性統計學意義(RR=1.30,95％ CI=0.99～1.71,P=0.05)；突髮性聾閤併糖尿病患者鼓室內應用糖皮質激素的有效率高于全身應用的有效率(RR =1.24,95％ CI=1.02～1.50,P=0.03).全身應用糖皮質激素的主要併髮癥為血糖升高,鼓室內給藥的併髮癥包括疼痛、一過性眩暈、中耳感染、永久性鼓膜穿孔等.結論 對于突髮性聾閤併糖尿病的患者初始治療優先攷慮鼓室內應用糖皮質激素,不伴糖尿病者仍首選全身應用糖皮質激素.
목적 계통평개비교고실내화전신응용당피질격소대우돌발성롱초시치료적유효성화안전성.방법 용국제Cochrane협작망방법,검색고실내화전신당피질격소용우돌발성롱초시치료적수궤대조시험,대부합입선표준적문헌제취자료진행Meta분석.결과 돌발성롱불반당뇨병환자고실내응용당피질격소적유효솔여전신응용적유효솔상비교,조간차이무통계학의의(RR=1.11,95％ CI=0.96 ～ 1.28,P=0.15),치유솔차이유림계성통계학의의(RR=1.30,95％ CI=0.99～1.71,P=0.05)；돌발성롱합병당뇨병환자고실내응용당피질격소적유효솔고우전신응용적유효솔(RR =1.24,95％ CI=1.02～1.50,P=0.03).전신응용당피질격소적주요병발증위혈당승고,고실내급약적병발증포괄동통、일과성현훈、중이감염、영구성고막천공등.결론 대우돌발성롱합병당뇨병적환자초시치료우선고필고실내응용당피질격소,불반당뇨병자잉수선전신응용당피질격소.
Objective To assess the effectiveness and safety of intratympanic versus systemic steroid therapy in the initial treatment of idiopathic sudden hearing loss.Methods An extensive search of the literature was performed in Pubmed and other available database from January,1980 to November,2011.After filtering by the criteria of Cochrane Collaboration,a meta-analysis was conducted.Results Nine studies met the criteria for meta-analysis,for idiopathic sudden hearing loss patients without diabetes received intratympanic steroid therapy,the improvement rate (RR =1.11,95％ CI =0.96-1.28,P =0.15) did not show any significance when compared with the patients received systemic therapy.While a significant difference of improvement rate occurred between intratympanic and systemic steroid therapy in the idiopathic sudden hearing loss patients with diabetes (RR =1.24,95％ CI =1.02-1.50,P =O.03).Conclusion For the initial therapy of idiopathic sudden hearing loss patients without diabetes,systemic steroid treatment still remains the first choice,but for the idiopathic sudden hearing loss patients with diabetes,intratympanic steroid treatment should be used for the initial treatment.
