不同类型及年龄突发性耳聋患者疗效分析

目的探讨不同年龄组突发性耳聋患者的听力损失类型及其疗效。方法将80例（91耳）耳聋患者根据不同年龄段分为3组：儿童组、青中年组、老年组,比较不同年龄组及不同听力损失类型患者的临床疗效。结果儿童组、青中年组、老年组治疗有效率分别为75．00％（12／16）、75．86％（22／29）、78．26％（36／46）,经比较差异无统计学意义（P〉0．05）。不同频率突发性耳聋患者的疗效分别为低频型96．00％（24／25）,高频型53．33％（16／30）,平坦、全聋型77．78％（28／36）,组间两两比较差异有统计学意义（P〈0．05）。结论不同年龄突发性耳聋患者的疗效无明显差异,低中频型的疗效最好,平坦型及全聋型其次,高频型的疗效最差,临床上可依据听力损失类型判断疗效。     

罂粟碱治疗突发性耳聋的疗效观察

罂粟碱治疗突发性耳聋的疗效观察龚龙岗，曾玉红罂粟碱是镇痛解痉药物，临床常用于胆绞痛、心绞痛、动脉痉挛及动脉性疼痛。我科自１９９０～１９９４年，用罂粟碱治疗突发性耳聋６０例（８８耳），另取３０例（４０耳）作对照组进行比较，发现有显著疗效，现报道如下。１...     

老年突发性耳聋近期疗效临床分析

目的：分析老年突发性耳聋患者药物治疗的近期疗效。方法：将突发性耳聋患者依据年龄分为老年组（年龄≥60岁,70例）和对照组（年龄〈60岁,70例）,7d一疗程,复查纯音测听结果,比较治疗前后听力改善情况。结果：老年组患者治疗前后患耳言语频率平均听阈提高,差异有统计学意义（P〈0．05）;老年组突聋患者发病时间（≤7d）治疗有效率为61．76％,老年组（发病时间〉7d）治疗有效率为38．89％,差异有统计学意义（P〈0．05）,老年性突聋患者总有效率为49．9％;老年突发性耳聋患者在中度耳聋以下（听阈〈55dB）有效率52％,对照组有效率84．62％,差异有统计学意义（P〈0．05）,而在中重度耳聋患者治疗率差异无统计学意义。结论：病程对于老年突发性耳聋患者预后有重要的影响,尽早的改善末梢血管微循环障碍,可以明显的改善预后;老年突聋患者的预后比年轻患者差。     

突发性耳聋的疗效探索

目的 探索突发性耳聋的有效治疗方案。方法 将我科近年来收治的394例突聋患者分为5组。第一组中西医结合治疗40例。在此基础上，第二组加体外反搏治疗44例，第三组加高压氧舱治疗46例，第四组加光量子血液疗法46例；第五组加声信息治疗52例。与之比较相应各组的中西医结合组分别为42例、44例、40例和40例。结果 第一组有效率70．0％，第二组有效率86．4％，第三组有效率89．1％，第四组有效率93．5％，第五组有效率88．5％。第一组与其余4组的疗效差异有显著性意义（P＜0．05）。结论 药物治疗的同时加用各种特殊治疗，均将取得更好的疗效。     

中西医结合治疗突发性耳聋疗效观察

目的比较中西医结合与单纯西医治疗突发性耳聋的疗效。方法将208例突发性耳聋患者随机分为治疗组和对照组,治疗组（103例）采用中西医结合方法治疗;对照组（105例）用纯西医方法治疗。结果治疗组治愈率为63.1%,有效率为92.2%;对照组治愈率为29.5%,有效率为67.6%。两组疗效比较差别有统计学意义（P〈0.05）。结论中西医结合治疗突发性耳聋的疗效明显高于单纯西医治疗。     

突发性耳聋的纯音听力测试分析

突发性耳聋的纯音听力测试分析柴玉明１詹志荣１突发性耳聋是一种突发原因未明的感音神经性聋，患者往往在瞬间或数小时内听力急剧下降，大部分达到重度聋或全聋，可伴有耳鸣或眩晕，听力损害多为单侧，少数为双侧。为了解突发性耳聋患者的听力下降程度与听力图状况，近年...     

中西医结合治疗突发性耳聋的疗效观察

目的 观察中西医结合治疗突发性耳聋的疗效。方法 60例突聋病人，随机抽取30例为中西医结合治疗组，30例为西医治疗对照组。结果 总有效率治疗组76．7％，对照组46．7％，治疗组的疗效优于对照组（P＜0．05）。结论 中西医结合治疗突聋值得推广。     

东菱克栓酶治疗突发性耳聋的疗效观察

使用东菱克橙酶治疗突发性耳聋３０例，并以３０例用激素治疗对照。结果显示：ＤＦ－５２１组有效率为７０％，治愈率２６．７％，疗效明显优于激素组。早期使用ＤＦ－５２１可使有效率提高到８９．５％，治愈率提高到４２．１％。伴眩晕者不影响疗效。     

混合氧治疗突发性耳聋疗效分析

混合氧治疗突发性耳聋疗效分析范文汉，贺玉梅，陈小宏目前，突发性耳聋的治疗多采用改善内耳血循环和代谢紊乱以增加内耳供氧量，常用血管扩张剂、抗凝血的药物及高压氧等。我院根据ＣＯ２能有效地扩张脑血管，增加脑及耳蜗血流量的原理，自１９８３年以来，行动物实验证...     

儿童青少年突发性聋的临床分析及近期疗效观察

目的通过分析儿童青少年突发性聋患者住院资料,总结儿童青少年突发性聋的临床特征及治疗方式,为临床工作提供指导;方法选取2014年2月-2017年7月住院治疗并有完整资料的5~18岁的突发性聋患者46例(48耳),按年龄及体重给予糖皮质激素、改善内耳微循环药物、营养神经药物等综合治疗,评价治疗后第7天、14天及30天效果;按听力损失程度、年龄、性别、就诊时间、伴发症状(眩晕/耳鸣)等影响因素进行分组并对组间疗效进行比较。结果 46例(48耳)患者中,男21例(22耳),女25例(26耳),年龄5~18岁,单耳发病44例,双耳发病2例,4耳(8.3%)例为轻度听力损失,9耳(18.8%)为中度听力损失,15耳(31.3%)为重度听力损失,20耳(41.7%)为极重度听力损失,伴发眩晕症状1例(29.2%),伴发耳鸣症状21耳(43.8%);综合治疗后痊愈5耳(10.4%),总有效率(37.5%);就诊时间小于1周、年龄小于12岁、听力损失程度轻、伴有耳鸣症状者治疗效果较好(P<0.05);结论儿童青少年突发性聋多为一侧重度以上听力损失,及早给予系统综合的治疗能提高该病的近期治愈率;     

不同年龄段突发性聋患者听力损失特征及疗效分析

目的分析不同年龄段突发性聋患者的听力学特征及疗效,为突发性聋的诊治提供参考。方法回顾性分析1 023例突发性聋患者的临床资料,按发病年龄将患者分为4～岁、15～岁、30～岁、40～岁、50～岁、≥60岁六个组,比较其性别、耳别、听力曲线类型、听力损失程度以及疗效在各年龄段的分布特点。结果 1 023例突聋患者中以15～岁、30～岁和40～岁组年龄段居多(共占68.23%),4～岁组最少(占3.91%);15～岁组男性较40～岁、≥60岁组少(P≤0.001);4～岁组与15～岁、30～岁、50～岁组年龄段患者比较,前者双耳发病居多(P<0.001);≥60岁与40～岁相比,前者左耳发病较少,双耳发病居多(P<0.001)。4～岁组与其他各年龄组相比较,重度与极重度听力损失比例较高(P<0.003);4～岁与30～岁、40～岁组比较,前者上升型、下降型较后者少,而平坦型、全聋型较后者多(P<0.001)。1 023例患者治疗后的总有效率为51.01%,15～岁组最高(63.90%),4～岁组总有效率最低(28.85%)。结论不同年龄段突发性聋患者听力损失特征及疗效各不相同,儿童患者双耳发病者较多,且听力损失程度重,疗效差,老年患者双耳发病较多;15～30岁患者疗效最好。     

Sudden Bilateral Sensorineural Hearing Loss

Most cases of sudden sensorineural hearing loss (SHL) remain idiopathic, and the majority are unilateral. From 1989 to 1993, 823 patients with sudden SHL were evaluated. Of these, 14 (1.7%) had sudden bilateral SHL. We reviewed the charts of these 14 patients to compare sudden bilateral SHL with sudden unilateral SHL. Usually, bilateral SHL was asymmetric. Most bilateral cases received combined steroid and vasodilator treatment, while unilateral cases were more likely to receive only one of these treatments. By audiological criteria, 67% of bilateral SHL cases improved, while the improvement rate in unilateral SHL was 52%; however, this difference was not statistically significant. In bilateral SHL patients showing improvement, both ears responded. Bilateral SHL patients were older at the onset of hearing loss, had a higher incidence of vascular disease, and were more likely to have positive antinuclear antibody titer. Recognition of similarities and differences between sudden unilateral and bilateral SHL can help in counseling patients.     

Outcomes of Severe to Profound Idiopathic Sudden Sensorineural Hearing Loss

Objectives

While a severe to profound sudden sensorineural hearing loss (SSNHL) may cause serious disability in verbal communication, there have been little studies focusing on this high degree SSNHL. The present study was aimed to investigate the characteristics of hearing recovery in a high degree SSNHL (>70 dB).

Methods

Three hundred and two SSNHL patients were enrolled. For a long-term follow-up, 46 patients were evaluated. Hearing level was examined by pure tone audiometry on day 1, week 3, month 3, month 6, and year 1 or after. According to the degree of the initial hearing loss, the patients were divided into 4 groups from 70 to ≥100 dB.

Results

After 3 weeks, the recovery rate and mean hearing gain was 61%, 23.85 dB in the 70 dB group, whereas 10%, 6.61 dB in the ≥100 dB group. There was a significant correlation between 3-week recovery and final hearing outcome. However, there was almost no recovery after 3 months.

Conclusion

An early recovery can be a prognostic factor for the final recovery in severe to profound SSNHL. Since recovery after 3 months is rare, an early hearing intervention like hearing aid or cochlear implantation should be considered in the high degree SSNHL to restore the patient''s verbal communication.     

自身免疫性感音神经性听力减退的测听结果

观察分析７１例（１３０耳）临床拟诊为自身免疫性感音神经性听力减退耳的听力学检查结果。听力图为低频减退者５５耳、平坦型者２６耳、钟型者１７耳、高频减退者３２耳。综合瞬态诱发耳声发射（ＴＥＯＡＥ）、听性脑干反应（ＡＢＲ）和耳蜗电图的－ＳＰ／ＡＰ振幅比的结果分析，这组患耳中低频减退型多为蜗后病变所致，且以３０岁以下者为多见；其余３型多为耳蜗病变所致，且多为３１岁以上者。鉴于约１／３患者以蜗后病变为主，称本病为自身免疫性内耳病似不恰当，值得商榷。     

Idiopathic Sudden Sensorineural Hearing Loss With Minimal Hearing Impairment

Objectives

The aim of the study was to determine the characteristics of patients who did not match the audiometric criteria of idiopathic sudden sensorineural hearing loss (SSNHL) but complained of acute hearing loss.

Methods

By thorough medical chart reviews, historical cohort study was performed with consecutive data of 589 patients complaining of acute unilateral sensorineural hearing loss without identifiable causes between 2005 and 2013. Those patients demonstrating a hearing loss of at least 30 dB at three consecutive frequencies based on pure tone audiometry were classified as group I; the others were classified as group II. Patients'' characteristics, final hearing, and hearing improvement rate (HIR) between the two groups were compared.

Results

Group II exhibited distinctive characteristics, including an early age of onset of the hearing loss (P<0.01), an absence of accompanying diabetes (P<0.01) and hypertension (P<0.01), and better unaffected hearing and final hearing compared with group I (P<0.001). However, the HIR of the patients in the two groups was not significantly different (P>0.05).

Conclusion

Patients who did not meet the audiological criteria of SSNHL exhibited distinctive characteristics compared to SSNHL patients.     

全频型突发性聋的疗效影响因素分析

目的通过比较溶栓治疗全频型突发性聋患者前后凝血功能的变化和疗效,探讨全频型突发性聋的疗效预测指标。方法对64例于2017至2018年间在我科治疗的全频型突发性聋患者的凝血功能进行回顾性分析。根据纯音听阈变化将其分为有效组(n=33)与无效组(n=31),比较治疗前后凝血功能指标。结果与治疗前比较,治疗后两组患者的Fbg水平显著降低、TT显著延长、APTT显著缩短(P<0.05)。有效组治疗前后的Fbg水平均低于无效组(P<0.05),且有效组治疗前TT水平高于无效组(P<0.05)。回归分析示高龄、右侧发病、较低的TT值是全频型突发性聋预后的危险因素。线性回归提示治疗前Fbg水平与听力提高负相关,治疗前后Fbg变化值与治疗后听力值负相关。结论全频型突发性聋预后与年龄、发病侧别、凝血功能指标相关,溶栓治疗全频型突发性聋能显著改善凝血功能状态,Fbg可作为全频型突发性聋预后的预测指标。     

儿童突发性感音神经性听力损失的诊治体会

对18例20耳8～14岁突发性感音神经性听力损失患儿的临床资料进行了总结和分析,结果表明儿童突发性感音神经性听力损失发病与首诊之间病程较长,部分患儿有上感、流行性腮腺炎病史,可能和听力损失发生有关.儿童突发性感音神经性听力损失治疗效果类似于成人患者,而全聋者疗效差.东菱克栓酶同样适于治疗儿童突发性感音神经性听力损失且疗效和安全性较好,无明显的出血倾向和其它并发症.     

少年儿童突发性聋的治疗及预后分析

目的探讨少年儿童突发性聋临床特点、治疗及预后因素分析。方法回顾性分析2011年1月至2016年12月间我科收治的78例(81耳)儿童突发性聋的病例资料。共收集病例78例,81耳,双耳3例,其中男性40例(51.28%),女性38例(48.72%)。年龄9-18岁,平均年龄15.69岁。按照听力曲线分型,低频下降型27例,中高频下降型9例,平坦型17例,全聋型25例。分析不同类型突发性聋患儿的临床特点及治疗效果,运用logistic回归分析其预后因素。Fisher检验比较不同类型突发性聋患儿是否采用特殊治疗(鼓室/耳后注射激素)对预后的影响。结果各种类型的总有效率:低频下降型最高,为96.30%;其次为平坦型,全聋型次之,分别为76.47%,52.00%;中高频型最差,为44.44%。所有患儿总有效率为71.79%。无耳鸣患儿14例,总有效率为50%;伴耳鸣患儿64例,总有效率为76.56%。4例患儿耳后注射复方倍他米松,1例有效;21例患者采用鼓室注射甲强龙,14例有效;3例患者采用联合鼓室注射甲强龙和耳后注射复方倍他米松,1例有效。多因素Logistic回归分析结果显示,突发性聋分型、是否伴发耳鸣与少年儿童突发性聋治疗效果相关。结论低频型、伴发耳鸣的少年儿童突发性聋患者预后好,中高频型、无耳鸣的患儿预后较差。耳后注射及鼓室注射激素对首次治疗无效的患儿仍然有效。