儿童突发性聋的临床特征及预后相关因素分析

doi:10.6040/j.issn.1673-3770.0.2018.019

摘要/Abstract

摘要： 目的分析儿童突发性聋的临床特征、疗效及影响预后的相关因素,为临床治疗及预后评估提供依据。方法收集2010年1月至2017年10月就诊的67例突发性聋患儿临床资料,对其临床特征及治疗效果进行回顾性分析,同时根据疗效将患者分为总体有效组(36例)及无效组(31例),采用单因素及多因素分析的方法分析患者的性别、年龄、病程、初诊听阈、是否伴发耳鸣、眩晕、病毒感染史、发病季节和听力曲线类型对预后的影响。结果儿童突聋患者中64.18%在春冬季发病,其就诊时听阈为(76.62±25.97)dB HL,耳鸣及眩晕伴发率分别为70.15%和61.19%,病毒感染率为19.40%,听力曲线中10.44%为低频下降型、2.99%为高频下降型、34.33%为平坦型及52.24%为全聋型。经治疗后,患者听阈为(60.41±31.52)dB HL,总体有效率为53.73%,其中痊愈率、显效率及有效率分别为20.90%、16.42%和16.42%。多因素分析结果显示,初诊听阈越高及听力曲线为全聋型,预后越差(P均<0.05);伴有病毒感染的非全聋型患者预后较好(P<0.05)。结论儿童突发性聋患者病毒感染率较高且大部分在春冬季发病,就诊时听力损失较重并常伴有耳鸣及眩晕,其听力曲线以平坦型及全聋型为主。就诊时听力损伤程度轻、伴有病毒感染的非全聋型患者预后较好。

关键词: 突发性聋, 儿童, 临床特征, 多因素分析

Abstract: Objective To analyze the clinical characteristics and prognostic factors for sudden idiopathic sensorineural hearing loss in children, and provide guidance for clinical practice and prognosis assessment. Methods We retrospectively analyzed clinical data from 67 pediatric sudden sensorineural hearing loss patients treated in our department from January 2010 to October 2017. The 67 patients were divided into two groups(recovery group and no-recovery group)on the basis of recovery of hearing. Univariate and multivariate analysis were used to examine factors associated with prognosis(sex, age, treatment onset, initial hearing threshold, presence of tinnitus and vertigo, history of viral infection, season, and audiogram configuration)for the recovery group and no-recovery group. Results 64.18% of pediatric patients showed onset of hearing loss in spring or winter. The average hearing threshold at initial presentation was 70.79±10.13 dB HL. As accompanying symptoms, 47 ears(70.15%)exhibited tinnitus, 41 ears(61.19%)exhibited vertigo, and the rate of viral infection was 19.40%. The audiogram configuration before hyperbaric oxygen therapy was ascending in 10.44%, descending in 2.99%, flat in 34.33%, and showed total deafness in 52.24% of cases. The average hearing threshold was 60.41±31.52 dB HL after treatment; the overall recovery rate was 53.73%; the complete recovery, marked recovery and recovery rates were 20.90%, 16.42% and 16.42%, respectively. According to the multivariate analysis, initial hearing threshold, total deafness and presence of viral infection had significant influences on prognosis(P<0.05). Conclusion Most pediatric patients experienced sudden sensorineural hearing loss in spring or winter, with a high rate of viral infections. The hearing loss was identified as severe, with high levels of tinnitus and vertigo, and most audiogram configurations either were flat or showed total deafness. Multivariate analysis revealed that lower initial hearing loss threshold, non-total deafness and history of viral infection were associated with a better prognosis.

Key words: Sudden sensorineural hearing loss, Clinical characteristics, Multivariate analysis, Children

中图分类号:

R764.43

许明,罗兴谷,唐洪波,江青山. 儿童突发性聋的临床特征及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 41-44.

XU Ming, LUO Xinggu, TANG Hongbo, JIANG Qingshan. Clinical characteristics and prognostic factors for sudden idiopathic sensorineural hearing loss in children[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 41-44.

参考文献 18

[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分会. 突发性聋诊断和治疗指南(2015)[J]. 中华耳鼻咽喉头颈外科杂志, 2015,50(6):443-447. Editorial Board of Chinese Journal of Otolaryngology head and neck surgery, Chinese Medical Association of Otolaryngology head and neck surgery. Guideline of diagnosis and treatment of sudden deafness(2015)[J]. Chin J Otolaryngology Head and Neck Surg, 2015, 50(6):443-447.
[2]	屈永涛,张慧平,陈红耀,等.鼓室内联合全身应用糖皮质激素治疗全聋型突发性聋[J].中华耳科学杂志,2016,14(3):388-391. QU Yongtao, ZHANG Huiping, CHEN Hongyao, et al. Combined systemic and intratympanic usage of steroids in sudden total sensorineural hearing loss[J]. Chin J Otology, 2016, 14(3):388-391.
[3]	侯志强,王秋菊.不同年龄段突聋患者的临床特点及预后研究进展[J].听力学及言语疾病杂志,2013,21(4):418-421. HOU Zhiqiang, WANG Qiuju. Research advance in clinical characteristics and recovery of sudden sensorineural hearing loss in different age groups[J]. J Audiol Speech Pathol, 2013, 21(4):418-421.
[4]	Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss[J]. Otol Neurotol, 2013, 34(9):1586-1589.
[5]	陈平,唐安洲,郑明华,等.突发性聋不同听力曲线类型的临床特征及疗效分析[J].临床耳鼻咽喉头颈外科杂志,2012,26(22):1043-1046. CHEN Ping, TANG Anzhou, ZHENG Minghua, et al. Clinical characteristics and recovery of sudden sensorineural hearing loss in different audiogram configurations[J]. J Clin Otolaryngology Head and Neck Surg, 2012, 26(22):1043-1046.
[6]	Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice guideline: sudden hearing loss[J]. Otolaryngol Head Neck Surg, 2012, 146(3 Suppl):S1-35.
[7]	Chen YS, Emmerling O, Ilgner J, et al. Idiopathic sudden sensorineural hearing loss in children[J]. Int J Pediatr Otorhinolaryngol, 2005, 69(6):817-821.
[8]	李凤娇,薛希均,王莉,等.儿童突发性聋患者的预后分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(22):1931-1935. LI Fengjiao, XUE Xijun, WANG Li, et al. Prognostic factors of sudden sensorineural hearing loss in children[J]. J Clin Otolaryngology Head and Neck Surg, 2012, 29(22):1931-1935.
[9]	谢邵兵,吴学文,强清芬,等.儿童及成人突发性聋预后的对比分析[J].中国耳鼻咽喉颅底外科杂志,2017,23(5):431-434, 438. XIE Shaobing, WU Xuewen, QIANG Qingfen, et al. Prognostic comparison of sudden sensorineural hearing loss in children and adults[J]. Chin J Otolaryngology Skull Base Surg, 2017, 23(5):431-434, 438.
[10]	Bogaz EA, Maranhão AS, Inoue DP, et al. Variables with prognostic value in the onset of idiopathic sudden sensorineural hearing loss[J]. Braz J Otorhinolaryngol, 2015, 81(5):520-526.
[11]	钱怡,钟时勋,胡国华,等.少年儿童突发性聋的治疗及预后分析[J].中华耳科学杂志,2017,15(5):531-537. QIAN Yi, ZHONG Shixun, HU Guohua, et al. Treatment and Prognosis of Sudden Sensorineural Hearing Loss in Children[J]. Chin J Otology, 2017, 15(5):531-537.
[12]	梁振,余力生,夏瑞明.全频突发性聋的分型探讨[J].中华耳鼻咽喉头颈外科杂志,2010,45(4):282-286. LIANG Zhen, YU Lisheng, XIA Ruiming. Analysis of sub-typing in full-frequency sudden deafness[J]. Chin J Otolaryngology Head and Neck Surg, 2010, 45(4):282-286.
[13]	董和霞,王晓辉.纤溶酶治疗全聋型或接近全聋型突发性聋的疗效观察[J].中华耳科学杂志,2011,9(3):300-302. DONG Hexia, WANG Xiaohui. Effects of fibrinogenase in treatment of complete or profound sudden deafness[J]. Chin J Otology, 2011, 9(3):300-302.
[14]	李凤娇,薛希均,王秋菊.儿童突发性聋的研究进展[J].听力学及言语疾病杂志,2015,23(5):549-553. LI Fengjiao, XUE Xijun, WANG Qiuju. Sudden sensorineural hearing loss in children[J]. J Audiol Speech Pathol, 2015, 23(5):549-553.
[15]	贺勇,董西见,殷鹏,等.40例儿童突发性耳聋的血清病毒检测和疗效分析[J].当代医学,2011,17(15):97-98. HE Yong, DONG Xijian, YIN Peng, et al. Serum virus detection and recovery analysis in 40 cases of pediatric sudden sensorineural hearing loss[J]. Contem Med, 2011, 17(15):97-98.
[16]	徐秀娟,许耀东,刘翔,等.少儿突发性聋临床特征分析[J].听力学及言语疾病杂志,2006,14(6):461-462. XU Xiujuan, XU Yaodong, LIU Xiang, et al. Analysis of clinical characteristics of pediatric sudden sensorineural hearing loss[J]. J Audiol Speech Pathol, 2006, 14(6):461-462.
[17]	林枫,吴宏,虞幼军.少儿突发性耳聋33例临床分析[J].实用医学杂志,2001,17(8):749-750. LIN Feng, WU Hong, YU Youjun. Clinical analysis of 33 cases of pediatric sudden sensorineural hearing loss[J]. J Pract Med, 2001, 17(8):749-750.
[18]	谢邵兵,易星,强清芬,等. 儿童突发性聋患者的临床特征及预后分析[J]. 听力学及言语疾病杂志,2017,25(6):587-590. XIE Shaobing, YI Xing, QIANG Qingfen, et al. Analysis of clinical characteristics for sudden sensorineural hearing loss in children[J]. J Audiol Speech Pathol, 2017, 25(6):587-590.

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