704例突发性耳聋疗效分析

doi:10.6040/j.issn.1673-3770.0.2019.052

摘要/Abstract

摘要： 目的

分析不同听力损失程度及听力曲线类型患者的疗效，为突发性耳聋的临床治疗提供参考。

方法

以2015 年1月至2018年12月于广州中医药大学附属中山中医院耳鼻咽喉科住院治疗且确诊及临床资料完整的704例（805耳）突发性耳聋患者为研究对象，对比分析不同听力损失程度的不同听力曲线类型突发性耳聋患者的疗效。

结果

172例低频下降型患者中，轻度与中度的痊愈率分别为64.66%、53.33%，差异无统计学意义（χ²=0.122，P=0.727），总有效率分别为78.66%、73.33%，差异无统计学意义（ χ²=0.012，P=0.913）；205例高频下降型患者中，轻度、中度、中-重度、重度者痊愈率分别为5.98%、4.34%、0、0，不同程度听力损失者的痊愈率差异无统计学意义（χ²=2.636，P=0.451），轻度、中度、中-重度、重度者总有效率分别为22.22%、19.56%、38.46%、40.00%，不同程度听力损失者的总有效率差异无统计学意义（χ²=5.067，P=0.167）；226例平坦下降型患者中，轻度、中度、中-重度、重度者痊愈率分别为34.14%、4.76%、10.44%、9.21%，轻度与中度、中重度及重度间差异有统计学意义（χ²=9.325、6.956、7.852，P=0.007、0.021、0.013），轻度、中度、中-重度、重度者总有效率分别为57.44%、37.09%、50.74%、52.63%，不同程度听力损失者的总有效率差异无统计学意义（χ²=4.103，P=0.129）；101例全聋型患者中，重度与极重度的痊愈率分别为12.50%、1.07%，差异有统计学意义（χ²=4.954，P=0.026），重度与极重度者的总有效率分别为62.50%，34.40%，差异无统计学意义（χ²=2.504，P=0.114）。

结论

听力损失程度对突发性聋的疗效有重要影响，除低频下降型外，其余听力曲线类型疗效均较差。

关键词: 突发性聋, 听力损失, 治疗结局

Abstract: Objective

To analyze the therapeutic outcome based on the hearing loss level and hearing curve in sudden deafness and to provide clinical treatment strategies.

Methods

In total, 704 patients (805 ears) with sudden deafness hospitalized in the Otorhinolaryngology Department of Zhongshan Hospital of Traditional Chinese Medicine from January 2015 to December 2018 were selected for the study. The therapeutic outcomes based on the hearing loss level and hearing curve in sudden deafness were compared and analyzed.

Results

Among 172 cases of low frequency hearing loss, the recovery rates of cases involving mild and moderate deafness were 64.66% and 53.33%, respectively, with no significant differences (χ²= 0.122; P = 0.727), and the total effective rates were 78.66% and 73.33%, respectively, with no significant differences (χ²= 0.012; P = 0.913). Among 205 cases involving high frequency hearing loss, the recovery rates of cases involving mild, moderate, moderate-severe, and severe deafness were 5.98%, 4.34%, 0%, and 0%, respectively, with no significant differences (χ²= 0.012; P = 0.913), and the total effective rates were 22.22%, 19.56%, 38.46%, and 40.00%, respectively, with no significant differences (χ²= 5.067; P = 0.167). Among 226 cases of flat hearing loss, the recovery rates of those with mild, moderate, moderate-severe, and severe deafness were 34.14%, 4.76%, 10.44%, and 9.21%, respectively, with no significant differences (χ² = 9.325, 6.956, and 7.852, respectively; P = 0.007, 0.021, and 0.013, respectively), and the total effective rates were 57.44%, 37.09%, 50.74%, and 52.63%, respectively, with no significant differences (χ² = 4.103; P = 0.129). Among 101 cases of total deafness, the recovery rates of cases involving severe and extremely severe deafness were 12.50% and 1.07%, respectively, which was statistically significant (χ² = 4.954; P = 0.026), and the total effective rates were 62.50% and 34.40%, respectively, with no significant differences (χ² = 2.504; P = 0.114).

Conclusions

The degree of hearing loss is a factor influencing the therapeutic outcome in sudden deafness. Except for low frequency hearing loss, all other types showed a poor therapeutic outcome.

Key words: Sudden deafness, Hearing loss, Theatment outcome

中图分类号:

R764.43

叶毅良,卢标清. 704例突发性耳聋疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 44-47.

Yiliang YE,Biaoqing LU. Therapeutic outcome analysis of 704 cases of sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 44-47.

参考文献 12

1	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会 . 突发性聋诊断和治疗指南(2015)[J]. 2015, 50(6): 443-447. doi:10.3760/cma.j.issn. 1673-0860.2015.06.002 . doi: 10.3760/cma.j.issn. 1673-0860.2015.06.002
2	马荣峰, 朱富高, 孙美红, 等 . 突发性聋预后的相关因素分析及疗程选择[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 69-74.
	MA Rongfeng , ZHU Fugao , SUN Meihong , et al . Analysis on the relevant prognostic factors of sudden deafness and selection of course of treatment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(4): 69-74.
3	司建平,杜海荣,严佳亮,等 .秦皇岛地区324例突发性聋患者疗效分析[J].中华耳科学杂志,2018,16(3):408-411.
4	中国突发性聋多中心临床研究协作组 . 中国突发性聋分型治疗的多中心临床研究[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(5) : 355-361. doi:10.3760/cma.j.issn.1673-0860.2013.05.002 . doi: 10.3760/cma.j.issn.1673-0860.2013.05.002
	Chinese sudden hearing loss multi-center clinical . Prospective clinical multi-center study on the treatment of sudden deafness with different typings in china[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2013, 48(5): 355-361. doi:10.3760/cma.j.issn.1673-0860.2013.05.002 . doi: 10.3760/cma.j.issn.1673-0860.2013.05.002
5	李宝环, 姜子刚 . 不同听力损失程度突发性聋疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(14): 1124-1126. doi:10.13201/j.issn.1001-1781.2016.14.008 . doi: 10.13201/j.issn.1001-1781.2016.14.008
	LI Baohuan , JIANG Zigang . Curative effect analysis of different degree of hearing loss in sudden deafness patients[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(14): 1124-1126. doi:10.13201/j.issn.1001-1781.2016.14.008 . doi: 10.13201/j.issn.1001-1781.2016.14.008
6	Cao XY , Liu YS , Lei MX , et al . Comparison of curative effect and prognosis analysis of patients with spinal metastases treated by percutaneous vertebroplasty combined with postoperative radiotherapy and radiotherapy alone[J]. Zhonghua Yi Xue Za Zhi, 2016, 96(47):3805-3810.
7	Li FJ , Wang DY , Wang HY , et al . Clinical study on 136 children with sudden sensorineural hearing loss[J]. Chinese Medical Journal, 2016,129(8):946-952.doi:10.4103/0366-6999.179791 . doi: 10.4103/0366-6999.179791
8	Tüzemen G . The importance of the first three days and other diagnostic indicators in sudden hearing loss[J]. Kulak Burun Bogaz Ihtis Derg, 2016, 26(6): 333-341. doi:10.5606/kbbihtisas.2016.66915 . doi: 10.5606/kbbihtisas.2016.66915
9	Choo OS , Yang SM , Park HY , et al . Differences in clinical characteristics and prognosis of sudden low- and high-frequency hearing loss[J]. The Laryngoscope, 2017, 127(8): 1878-1884. doi:10.1002/lary.26382 . doi: 10.1002/lary.26382
10	Lee HS , Lee YJ , Kang BS , et al . A clinical analysis of sudden sensorineural hearing loss cases[J]. Korean J Audiol, 2014, 18(2): 69. doi:10.7874/kja.2014.18.2.69 . doi: 10.7874/kja.2014.18.2.69
11	司建平, 姜子刚, 杨丽莉, 等 . 全频下降型突发性聋患者听力初始恢复频率与预后相关性研究[J]. 中国耳鼻咽喉头颈外科, 2017, 24(10): 547-548. doi:10.16066/j.1672-7002.2017.10.015 . doi: 10.16066/j.1672-7002.2017.10.015
12	Bae SC , Noh HI , Jun BC , et al . Efficacy of intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss: comparison with systemic steroid therapy and combined therapy[J]. Acta Oto-Laryngologica, 2013, 133(5): 428-433. doi:10.3109/00016489. 2012. 749520 . doi: 10.3109/00016489. 2012. 749520

相关文章 15

[1]	梁程程,王欣,雷大鹏. 电子鼻咽喉镜诊治27400例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 107-110.
[2]	陈蔚华,张凯扬,郑晓彬. 小儿喉、气管、支气管异物221例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 111-115.
[3]	吴兆坤,朱新华. 腺样体扁桃体切除术治愈儿童阻塞性睡眠呼吸暂停综合征的偏误研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 148-152.
[4]	李传硕,李永团,曹海南,张孟璐. 眩晕患者的行为类型量化分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 32-36.
[5]	刘鸣. 早期声门癌的内镜治疗[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 6-9.
[6]	申宇鹏,宋琦,李晓明. 喉癌前病变的病因、分子机制和处理策略[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 25-30.
[7]	钟晓声,杨海弟,郑亿庆. 突发性聋伴耳鸣的治疗与转归[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 43-46.
[8]	赵俊英,王建明. 单侧突发性聋与椎基底动脉影像学特征的相关性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 47-51.
[9]	张俊军,刘海莉,刘加福,秦小奉,杜洪明,王厚慧. 糖皮质激素不同给药方式治疗突发性聋的临床疗效及安全性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 52-55.
[10]	张贵阳,黄河,冼志,张汉文,谢桂彩. 粉尘螨滴剂舌下含服免疫治疗对不同年龄段变应性鼻炎患者的临床效果评估[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 60-65.
[11]	罗通勇,杨华清,岳胜清,贾全凡,袁龙. 帕尼单抗和紫杉醇一线治疗复发或转移性头颈肿瘤Ⅱ期患者效果观察[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 71-75.
[12]	童巧珍,赵艳,程四华. 突发性聋患者负性情绪知信行模式构建及应用效果[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 162-164.
[13]	郎永耀,杨云,刘晴,徐林弟,林子萍. 咽喉反流性疾病的影响因素及治疗效果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 119-123.
[14]	卜行宽. WHO全球防聋计划和我国的响应与作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 3-8.
[15]	王登元,陈智斌,王杪琳. 伴发梅尼埃病的良性阵发性位置性眩晕的临床特点[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 61-65.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed