摘要
目的探讨耳后和鼓室内注射糖皮质激素治疗突发性聋的有效性及安全性。方法通过在中国知网、万方、维普、Pubmed、Cochrane和Embase等数据库检索自建库以来至2022年9月国内外公开发表的耳后和鼓室内注射糖皮质激素治疗突发性聋的随机对照研究,对符合纳入标准的研究进行Meta分析。结果本研究共检索1723篇,通过筛选后共纳入符合要求的文献33篇,其中1篇英文文献,其余均为中文文献。耳后组和鼓室组总有效率无显著性差异(RR=1.02,95%CI为0.98~1.07,Z=1.20,P=0.23),耳后组的治愈率明显高于鼓室组(RR=1.14,95%CI为1.00~1.29,Z=2.03,P=0.04)。通过亚组分析,耳后组和鼓室组合并突聋的糖尿病患者总有效率无显著性差异(RR=1.08,95%CI为0.99~1.17,Z=1.71,P=0.09)。在难治型的突聋患者的治疗中,鼓室组的有效率高于耳后组(RR=0.88,95%CI为0.80~0.97,Z=2.56,P=0.01)。两组之间耳鸣的有效率无显著性差异(RR=1.11,95%CI为0.95~1.30,Z=1.33,P=0.18)。在安全性比较方面,耳后组明显好于鼓室组(RR=0.33,95%CI为0.25~0.44,Z=7.57,P<0.01)。结论通过耳后注射糖皮质激素能获得和鼓室注射相似甚至更好的疗效。与鼓室注射相比,耳后注射更安全。
Objective To compare efficacy and safety of postauricular and tympanic glucocorticoid injection in the treatment of sudden deafness.Methods Randomized controlled studies on treatment of sudden deafness involving postauricular or intratympanic glucocorticoid injection published at home and abroad up to September 2022 were retrieved from the CNKI,Wanfang,VIP,Pubmed,Cochrane and EMBASE databases for a meta-analysis.Results A total of 1,723 articles were retrieved and 33 eligible articles,including one published in English,were included in the meta-analysis.The rate of total effectiveness showed no significant difference between postauricular and the intratympanic injections(RR=1.02,95%CI:0.98-1.07,Z=1.20,P=0.23),although the rate of recovery in postauricular injection was higher than in intratympanic injection(RR=1.14,95%CI:1.00-1.29,Z=2.03,P=0.04).Postauricular and the intratympanic injections showed no significant difference regarding rates of total effectiveness in patients with diabetes(RR=1.08,95%CI:0.99-1.17,Z=1.71,P=0.09).For patients with refractory sudden deafness,intratympanic injection showed higher rates of effectiveness than postauricular injection(RR=0.88,95%CI:0.80-0.97,Z=2.56,P=0.01).There was no significant difference in tinnitus improvement between the two approaches(RR=1.11,95%CI:0.95-1.30,Z=1.33,P=0.18).In terms of safety,postauricular injection performed better than intratympanic injection(RR=0.33,95%CI:0.25-0.44,Z=7.57,P<0.01).Conclusion Postauricular glucocorticoid injection can achieve similar or better therapeutic efficacy than intratympanic injection with better safety.
作者
熊健
伍利香
曾甦漪
林伟
窦艳玲
方丽
张杰
XIONG Jian;WU Lixiang;ZENG Suyi;LIN Wei;DOU Yanling;FANG Li;ZHANG Jie(Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Chengdu University,Chengdu 610081,China;不详)
出处
《中华耳科学杂志》
CSCD
北大核心
2024年第5期798-806,共9页
Chinese Journal of Otology
关键词
突发性聋
耳后注射
鼓室内注射
糖皮质激素
META分析
sudden deafness
postauricular injection
intratympanic injection
glucocorticoid
meta-analysis
