突发性聋不同听力曲线类型的临床特征及疗效分析
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摘要
目的:分析突发性聋不同听力曲线类型住院患者的临床特征及疗效,为突发性聋的诊治工作提供参考。方法:回顾性分析1 033例突发性聋住院患者的资料,比较其性别、耳侧、不同年龄段、伴发耳鸣眩晕情况、听力损失程度以及疗效在不同听力曲线类型的分布特点。结果:突发性聋患者以平坦型居多(27.24%),峰谷型最少(5.94%);性别分布:男女比例为1.3∶1.0,其中上升型女性比率较下降型、平坦型、全聋型多(P<0.01)。耳侧分布:平坦型双耳发病者较上升型多(P<0.01)。年龄分布:平坦型在≥60岁年龄段的分布显著高于上升型(P<0.01)。全聋型与其他各型、下降型与上升型相比,眩晕的发生率存在统计学差异(P<0.01)。峰谷型的耳鸣发生率高于平坦型(P<0.01)。听力损失程度分布:全聋型在极重度聋的分布显著高于其它各型(P<0.01),平坦型在重度聋的分布明显高于其它各型(P<0.01)。治疗总有效率为51.01%,上升型、峰谷形的总有效率较下降型、平坦型、全聋型好(P<0.01);全聋型的总有效率较其他各型差(P<0.01)。结论:突发性聋患者不同听力曲线的特征及疗效各不相同,其中平坦型最多,峰谷型最少;疗效以上升型和峰谷型最好,全聋型最差,听力损失程度及有否伴发眩晕和疗效密切相关。
Objective:To analyze characteristics and curative effect of sudden sensorineural hearing loss(SSHL) inpatients with different audiometric curve and provide the reference for the diagnosis and treatment of SSHL.Method:Retrospective analyze of 1 033 cases of SSHL inpatients,compare the gender,the ears,the ages,with or without tinnitus and vertigo,hearing loss degree and the efficacy of distribution characteristics in different audiometric curves.Result:Inpatients with SSHL are mostly flat(27.24%),peak valley at least(5.94%);Gender distribution: male to female ratio was 1.3∶1,audiometric curve for the rise type more than the decline type and flat type and completely deafness type(P<0.01) in female.The ears distribution: the flat type more than increase type(P<0.01) in double eras SSHL.The age distribution: the flat type more than 60 years of age was significantly higher than that rising type(P<0.01).Completely deafness type compared with the other types,the decline type compared with the rise type,the incidence of vertigo was significantly different(P<0.01).Peak valley type with tinnitus was higher than the flat type.Degree of hearing loss distribution: completely deaf type in the very severe hearing loss was significantly higher than other types(P<0.01),flat type in severe hearing loss was significantly higher than other types(P<0.01).The total effective rate was 51.01%.Rise type,peak valley type were more efficient than other types(P<0.01);completely deafness type was less efficient than other types(P<0.01).Conclusion:The characteristics and curative effect are different in SSHL inpatients with different audiometric curves.Flat type was the most,peak valley type was the least.The curative effect of rise type and peak valley type are the best,completely deafness type is the worst.The degree of hearing loss and whether associated with vertigo is closely related in efficacy.
Objective:To analyze characteristics and curative effect of sudden sensorineural hearing loss(SSHL) inpatients with different audiometric curve and provide the reference for the diagnosis and treatment of SSHL.Method:Retrospective analyze of 1 033 cases of SSHL inpatients,compare the gender,the ears,the ages,with or without tinnitus and vertigo,hearing loss degree and the efficacy of distribution characteristics in different audiometric curves.Result:Inpatients with SSHL are mostly flat(27.24%),peak valley at least(5.94%);Gender distribution: male to female ratio was 1.3∶1,audiometric curve for the rise type more than the decline type and flat type and completely deafness type(P<0.01) in female.The ears distribution: the flat type more than increase type(P<0.01) in double eras SSHL.The age distribution: the flat type more than 60 years of age was significantly higher than that rising type(P<0.01).Completely deafness type compared with the other types,the decline type compared with the rise type,the incidence of vertigo was significantly different(P<0.01).Peak valley type with tinnitus was higher than the flat type.Degree of hearing loss distribution: completely deaf type in the very severe hearing loss was significantly higher than other types(P<0.01),flat type in severe hearing loss was significantly higher than other types(P<0.01).The total effective rate was 51.01%.Rise type,peak valley type were more efficient than other types(P<0.01);completely deafness type was less efficient than other types(P<0.01).Conclusion:The characteristics and curative effect are different in SSHL inpatients with different audiometric curves.Flat type was the most,peak valley type was the least.The curative effect of rise type and peak valley type are the best,completely deafness type is the worst.The degree of hearing loss and whether associated with vertigo is closely related in efficacy.
引文
[1]马芙蓉,谢立峰,赵一鸣.突发性耳聋预后因素回归树分析[J].中国耳鼻咽喉头颈外科杂志,2005,12(9):577-579.
[2]叶放蕾,帅华,张改霞.影响突发性聋预后的相关因素分析[J].听力学及语言疾病杂志,2011,19(1):66-67.
[3]吴继春,刘业海,黄新生.治疗前听力曲线形状与突发性聋预后关系分析[J].中华耳科学杂志,2011,9(1):34-37.
[4]中华医学会耳鼻咽喉科学会,中华耳鼻咽喉科杂志编委会.突发性聋诊断和疗效分级[J].中华耳鼻咽喉科杂志,1997,32(1):72-72.
[5]卜行宽,刘铤.世界卫生组织预防聋和听力减退工作情况[J].中华耳鼻咽喉科杂志,2000,35(3):237-239.
[6]修世国,刘艳丽,叶辉.突发性聋患者纯音听阈曲线与临床疗效关系的分析[J].听力学及语言疾病杂志,2008,16(6):516-517.
[7]卫旭东,何健.突发性聋预后因素分析[J].临床耳鼻咽喉头颈外科杂志,2011,25(13):599-601.
[8]陈平,徐志文.以耳闷为首发症状的突发性聋15例诊治分析[J].临床耳鼻咽喉科杂志,2005,19(12):562-563.
[9]马鑫,李蔷,静媛媛,等.突发性聋伴发眩晕的初步探讨[J].临床耳鼻咽喉头颈外科杂志,2010,21(19):883-885.
[10]张毅,纪维纲,尚建平.突发性聋的听力图型与听力转归关系探讨[J].听力学及语言疾病杂志,2000,8(2):109-110.
[11]CHEN C Y,HALPIN C,RAUCH S D.Oral steroidtreatment of sudden sensorineural hearing loss:a tenyear retrospective analysis[J].Otol Neurotol,2003,24:728-733.
[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.
[2]叶放蕾,帅华,张改霞.影响突发性聋预后的相关因素分析[J].听力学及语言疾病杂志,2011,19(1):66-67.
[3]吴继春,刘业海,黄新生.治疗前听力曲线形状与突发性聋预后关系分析[J].中华耳科学杂志,2011,9(1):34-37.
[4]中华医学会耳鼻咽喉科学会,中华耳鼻咽喉科杂志编委会.突发性聋诊断和疗效分级[J].中华耳鼻咽喉科杂志,1997,32(1):72-72.
[5]卜行宽,刘铤.世界卫生组织预防聋和听力减退工作情况[J].中华耳鼻咽喉科杂志,2000,35(3):237-239.
[6]修世国,刘艳丽,叶辉.突发性聋患者纯音听阈曲线与临床疗效关系的分析[J].听力学及语言疾病杂志,2008,16(6):516-517.
[7]卫旭东,何健.突发性聋预后因素分析[J].临床耳鼻咽喉头颈外科杂志,2011,25(13):599-601.
[8]陈平,徐志文.以耳闷为首发症状的突发性聋15例诊治分析[J].临床耳鼻咽喉科杂志,2005,19(12):562-563.
[9]马鑫,李蔷,静媛媛,等.突发性聋伴发眩晕的初步探讨[J].临床耳鼻咽喉头颈外科杂志,2010,21(19):883-885.
[10]张毅,纪维纲,尚建平.突发性聋的听力图型与听力转归关系探讨[J].听力学及语言疾病杂志,2000,8(2):109-110.
[11]CHEN C Y,HALPIN C,RAUCH S D.Oral steroidtreatment of sudden sensorineural hearing loss:a tenyear retrospective analysis[J].Otol Neurotol,2003,24:728-733.
[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.