摘要
目的:探讨1%利多卡因联合甲钴胺星状神经节阻滞治疗慢性特发性耳鸣的临床价值。方法:选取我院就诊的慢性特发性耳鸣患者80例,根据随机数字表法将患者分为观察组和对照组,各40例。对照组口服长春胺缓释胶囊和甲钴胺片,观察组在对照组基础上给予1%利多卡因4 ml+甲钴胺1 ml双侧交替星状神经节阻滞。比较两组治疗前后耳鸣心理声学特征及THI评分。比较两组患者耳鸣治疗效果。观察并记录观察组患者星状神经节阻滞后不良反应。结果:观察组与对照组治疗后1个月耳鸣响度、耳鸣主频率及THI评分较治疗前降低(均P<0.05)。与对照组比较,观察组治疗后1个月耳鸣响度及耳鸣主频率降低(均P<0.05)。治疗后1个月,观察组显效率和总有效率高于对照组(均P<0.05)。观察组所有患者星状神经节阻滞成功,未发生气胸、局部血肿、局麻药物中毒及声嘶等不良反应,阻滞成功后Horner综合征均自行缓解。结论:低浓度利多卡因联合甲钴胺行星状神经节阻滞治疗慢性特发性耳鸣可降低患者耳鸣响度及耳鸣主频率,减轻耳鸣严重程度,疗效显著且安全性较好。
Objective:To investigate the clinical value of stellate ganglion block with 1%lidocaine combined with mecobalamin in the treatment of chronic idiopathic tinnitus.Methods:A total of 80 patients with chronic idiopathic tinnitus treated at our hospital were selected and randomly divided into an observation group and a control group,with 40 cases in each group.The control group was administered oral vinpocetine sustained-release capsules and mecobalamin tablets,while the observation group received an additional stellate ganglion block with 1%lidocaine 4 ml+mecobalamin 1 ml on both sides alternately on the basis of the control group.The psychological acoustic characteristics and THI scores in both groups were compared before and after treatment.The tinnitus treatment effects of the two groups were compared.Adverse reactions after stellate ganglion block in the observation group were observed and recorded.Results:One month after treatment,the loudness of tinnitus,the main frequency of tinnitus,and the THI score in both the observation and control groups were reduced compared to before treatment(all P<0.05).Compared with the control group,the loudness of tinnitus and the main frequency of tinnitus in the observation group were reduced one month after treatment(all P<0.05).The effective rate and total effective rate of the observation group one month after treatment were higher than those of the control group(all P<0.05).All patients in the observation group successfully underwent stellate ganglion block,with no adverse reactions such as pneumothorax,local hematoma,local anesthetic drug toxicity and hoarseness.Horner’s syndrome occurred after the block and resolved spontaneously.Conclusion:Low-concentration lidocaine combined with mecobalamin for stellate ganglion block in the treatment of chronic idiopathic tinnitus can reduce the loudness and main frequency of tinnitus,alleviate the severity of tinnitus,and has significant efficacy and safety.
作者
王冰
王馨
赵紫玉
王晖
张文
刘晖
李安
宋佳音
WANG Bing;WANG Xin;ZHAO Ziyu;WANG Hui;ZHANG Wen;LIU Hui;LI An;SONG Jiayin(Department of Otorhinolaryngology Head and Neck Surgery,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)
出处
《陕西医学杂志》
CAS
2024年第11期1521-1524,1528,共5页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(82203114)
陕西省创新能力支撑计划项目(2022TD-51)
陕西省人民医院科技人才支持计划项目(2023JY-32)。
关键词
特发性耳鸣
慢性耳鸣
星状神经节阻滞
耳鸣心理声学测试
耳鸣障碍量表
安全性
Idiopathic tinnitus
Chronic tinnitus
Stellate ganglion block
Tinnitus psychoacoustic testing
Tinnitus handicap inventory
Safety
