突发性聋疗效评估的时机探讨

目的:探讨突发性聋疗效评估的最佳时机,以便更加准确真实地评估某种治疗方案对突发性聋的疗效。方法:分析112例突发性聋患者在治疗开始后的第3、7、14d和第1、2、3、4个月的听力情况。结果:治疗后第3天及治疗后第7天所测得的总有效率与其他时间点测得的结果比较差异均有统计学意义;治疗后第14天与第1个月测得的总有效率比较差异无统计学意义,与第2、3、4个月比较差异有统计学意义;治疗后第1个月与第2、3、4个月比较,尽管差异无统计学意义,但总有效率有较大的波动。治疗后第2个月与第3、4个月及治疗后第3个月与第4个月比较差异无统计学意义,且总有效率的绝对值也没有明显改变。从不同时间点的听力恢复情况来看,就总有效率而言,治疗开始后第3天,有效的病例数明显增加,直到第60天后,进入一个平台期。如果将各个时间点的治愈率、显效率和有效率分别来看,自治疗开始后到第14天,治愈、显效和有效病例增加明显,第14天后,进入一个平台期。结论:①突发性聋疗效评估结果与所采用的不同的评估时间点有关;②治疗14d后的听力测试情况可对总的疗效趋势作出一个大致的判断,在2周内听力提高的患者有可能获得较好的最终听力恢复;③在治疗2个月后突发性聋疗效进入一个稳定期,此时的听力学水平对评估突发性聋的疗效更加客观和准确。

The evaluating time of curative effect on sudden deafness

Objective:To explore the best evaluating time of curative effect on sudden deafness so that the curative effect on sudden deafness can been evaluated more exactly and literally.Method:Pure tone audiometries in 112 cases of sudden deafness were performed on the pretreatment day and on the third,seventh,fourteenth post-treatment day,and in the first,second,third,fourth post-treatment month.All of acoustical data were analyzed.Result:The total effective rates were statistical different between the third,seventh post-treatment day and the fourteenth post-treatment day,the first,second,third,fourth post-treatment month.There were no statistical difference between the fourteenth post-treatment day and the first post-treatment month.There were statistical difference between the fourteenth post-treatment day and the second,third,fourth post-treatment month.The total effective rates were no statistical difference between the first and the second,third,fourth post-treatment month but it was fluctuated in the first post-treatment month.The total effective rates were no statistical difference between the second and the third,fourth post-treatment month and it was changeless on the second post-treatment month.From the curve of recruitment of hearing in different time,the curve of the total effective rates ascend from the third post-treatment day,then get to plateau from the second post-treatment month.If the cure rates,the efficiency rates,the effective rates in different time were analyzed,respectively,the hearing improvement ascend in first two weeks then.Hearing improvement get to plateau from fourteenth post-treatment day.Conclusion:①The evaluated results of curative effect to sudden deafness correlated vary in different time point post-treatment.②Prognosis can be predicted approximately 2 weeks after treatment.Patients who recover acoustic sensibility within 2 weeks have more significant improvement than the patients who hearing improvement after 2 weeks treatment.③The results of curative effect are stable after 2 months.If the data of this time were adopted,it would be more objective and accurate to evaluate the curative effect on sudden deafness.