Hyperbaric oxygenation in early treatment of sudden deafness

BACKGROUND: The treatment of sudden deafness with hyperbaric oxygenation (HBO) is a new method, which is a routine application in some German centers and subject to contraindications can be assessed as relatively reliable. PATIENTS AND METHODS: In a retrospective study, data were analyzed from 49 patients who had received primary HBO therapy because of sudden deafness (up to 3 weeks old). In comparison to the standard infusion therapy according to Michel, the primary HBO therapy led to inferior results (no change in hearing: right ear 63.88%, left ear 60.98%; improvement in hearing: right ear 22.49%, left ear 21.71%; decrease in hearing: right ear 13.64%, left ear 17.32%). RESULTS: Considering the spontaneous remission of sudden deafness, neither the results of the infusion therapy nor those of the hyperbaric oxygenation surpass the rate of complete spontaneous remission. On the basis of our research, primary treatment of "fresh" sudden deafness with hyperbaric oxygenation cannot be recommended. CONCLUSIONS: The question remains open whether HBO as a secondary treatment for sudden deafness leads to improvements for the patient after unsuccessful standard therapy.     

突发性聋患者血液易栓症结果分析

目的通过分析突发性聋(sudden deafness,SD)患者血液中各项易栓症(thrombophlilia)的发生率,进一步明确突聋的发病原因及指导临床诊疗。方法选择我科2009年11月～2010年7月期间诊断明确的突聋患者43例(43耳)为突聋组,另选30例健康体检者为对照组,对所有受试者的遗传性易栓症指标包括抗凝血酶Ⅲ(AT-Ⅲ)活性、蛋白C(PC)活性、蛋白S(PS)活性、血清同型半胱氨酸(Hcy)及获得性易栓症指标D-二聚体(D-D)的阳性率进行分析。结果 43例突聋患者遗传性易栓症的总发生率为46.5%,其中Hcy的阳性率为44.1%,PS阳性率为23.3%;获得性易栓症D-D的阳性率为67.4%,与对照组比较,差异有统计学意义(P<0.05),AT-Ⅲ、PC两组比较差异无统计学意义(P>0.05)。结论突聋患者易栓症发病率高,尤其是获得性易栓症,其血液高凝状态可能是由遗传性和获得性易栓症共同作用的结果。     

突发性聋住院患者焦虑抑郁状况分析

目的对突发性聋患者焦虑抑郁状况及影响因素进行分析。方法收集突聋患者93例,采用焦虑(SAS)和抑郁(SDS)自评量表对突聋患者进行评价,并应用THI耳鸣残疾评估量表和耳鸣评估量表进行耳鸣评估,分析突聋患者患病后焦虑抑郁状态和造成这种心理状态的原因及对疗效的影响。结果 1.焦虑抑郁和性别、年龄、城乡差异、发病天数、听力损失程度无关,P>0.05,无统计学意义。2.突聋组SAS评分(47.07±9.64),正常组评分(37.70±9.21)相比较,P=0.00<0.05,差异有统计学意义,和中耳炎组评分(40.70±9.18)比较,P=0.00<0.05,差异有统计学意义;突聋组SDS评分(51.92±11.22),正常组评分(41.82±8.26)相比较,P=0.00<0.05差异有统计学意义,和中耳炎组评分(42.14±8.02)比较,P=0.00<0.05,差异有统计学意义。耳鸣和焦虑抑郁之间存在相关性,P=0.00<0.05差异有统计学意义。3.焦虑抑郁和眩晕、耳闷无关,P>0.05,无统计学意义。4.突聋患者中有焦虑抑郁组耳鸣量表和THI各维度评分均高于无焦虑抑郁组P<0.05,差异有统计学意义。5.治疗后的总有效率有焦虑组为16.1%,无焦虑组为31.2%,P>0.05,无统计学差异;总有效率有抑郁组为15.0%,无抑郁组为32.3%,P<0.05,有统计学差异。结论突聋患者心理健康状况较差,主要原因是耳鸣,并且抑郁的心理状态会影响疗效,需要对患者进行及时心理疏导。     

心理因素对突发性聋发病的影响

突发性聋，即突然发生的原因不明的感音神经性聋。询问病史可发现多数患者发病与身心过度疲劳、焦虑抑郁等情绪波动有关。通过对就诊于我科的46例突发性聋患者的研究，从发病前负性生活事件调查、发病后心理量表评分和血浆5-羟色胺浓度测定的关系着手，来揭示突发性聋的发病与心理因素的相关性。     

高压氧治疗突发性聋的再评价

目的　观察突发性聋高压氧 (hyperbaricoxygenation ,HBO)治疗前后血清脂质过氧化物代谢产物丙二醛 (maiondialdehyde ,MDA)和超氧化物歧化酶 (superoxidedismntase ,SOD)的浓度变化及对高压氧治疗效果的影响。方法　 6 0例 79耳突发性聋的患者 ,随机分为综合组 30例 43耳和单纯组 (单纯高压氧组 ) 30例 36耳 ,另有 30名健康志愿者做正常组。治疗前后比较听力变化 ,用硫代巴比妥酸法检测MDA、用放射免疫法检测SOD。结果　 2组治疗后听力比较 ,差异有显著性意义 ( χ2 =6 .48,P<0 .0 5 )。SOD测试 :综合组治疗后与正常组、单纯组比较 ,差异均有非常显著性意义 (前者t=2 3 2 7,P <0 .0 1,后者t =2 7.17,P <0 .0 1) ;综合组治疗前后比较 ,差异有非常显著性意义 (t =2 9.2 7,P <0 .0 1) ;单纯组治疗前后比较 ,差异无显著性意义 (t=1.33,P >0 .0 5 )。MDA测试 :综合组与单纯组治疗后比较 ,差异有非常显著性意义 (t=8.86 ,P <0 .0 1) ;综合组治疗前后比较 ,差异有非常显著性意义 (t=7.2 8,P <0 .0 1) ;综合组治疗后与正常组比较 ,差异无显著性意义 (t=1.2 4,P >0 .0 5 ) ;单纯组治疗后与正常组比较 ,差异有非常显著性意义 (t=7.0 9,P <0 .0 1)。结论　单纯高压氧治疗突发性聋的治愈率极低。     

突发性聋伴耳鸣的治疗与转归

研究分析突发性聋伴耳鸣患者的治疗与转归情况。     

尿毒症合并突发性聋患者的临床特征及预后

目的 分析尿毒症合并突发性聋(突聋)患者的临床特征及预后.方法 收集2015年1月-2019年12月在会理县人民医院治疗的尿毒症合并突聋患者29例(30耳),平均初诊听阈值为(62.33±13.68)dB HL;17耳(56.67％)伴耳鸣,8耳(26.67％)伴眩晕;9耳(30.00％)为平坦型,13耳(43.33％...     

高压氧治疗突发性聋的再评价

目的 观察突发性聋高压氧（ｈｙｐｅｒｂａｒｉｃ ｏｘｙｇｅｎａｔｉｏｎ,ＨＢＯ）治疗前后血清脂质过氧化物代谢产物丙二醛（ｍａｉｏｎｄｉａｌｄｅｈｙｄｅ,ＭＤＡ）和超氧化物歧化酶（ｓｕｐｅｒｏｘｉｄｅ ｄｉｓｍｎｔａｓｅ,ＳＯＤ）的浓度变化及对高压氧治疗效果的影响。方法 ６０例７９耳突发性聋的患者,随机分为综合组３０例４３耳和单纯组（单纯高压氧组）３０例３６耳,另有３０名健康志愿者做正常组。治疗前后     

突发性聋患者的人格特征分析

目的　探讨突发性聋患者的人格特征及发病的人群分布,了解该患病群体的心理健康情况。方法　采用明尼苏达多项人格测量表（Minnesota multiphasic personality inventory,MMPI）,对118例突发性聋患者及100例健康志愿者测试并进行对照性研究。结果　突发性聋患者在疑病（Hs）、抑郁（D）、情绪不稳定（Pd）、精神衰弱（Pt）及社会内向（Si）等方面MMPI量表因子分高于健康对照组,差异具有统计学意义,伴有耳鸣患者焦虑情绪更重,31～50岁是突发性聋发病的高发年龄。结论　突发性聋患者有情绪不稳定和较多的心理健康问题。     

突发性聋患者的人格特征分析

目的：探讨突发性聋患者的人格特征。方法：采用成人艾森克人格问卷（EPQ）从精神质（P）、内外向（E）、情绪性（N）、掩饰性（L）4个维度对38例突发性聋患者（突聋组）和45例正常健康者（对照组）进行对照研究。结果：突聋组P、E、N标准（T）分均高于对照组,L标准（T）分均低于对照组。2组比较P分、N分差异均有统计学意义（分别为P〈0.05和P〈0.01）,而2组E分、L分差异无统计学意义（P〉0.05）。结论：突发性聋患者具有情绪不稳定和精神质个性特征。     

Treatment of sudden deafness with xantinolnicotinate (Complamin) in increasing dosage

Twenty-nine patients affected by typical unilateral sudden hearing loss were treated with Xantinolnicotinate (Complamin) by a 21 days infusion of 1.5 g-30 g in 500 ml NaCl 0.9% followed by 3 months 1,000 mg sustained release tablets t.i.d. An improvement in hearing was achieved in 90.5% of the cases and in 52% returned to normal. Tinnitus improved in 92% of cases and resolved completely in 54%. The results of speech and sound audiograms correlated well, and showed significant recovery in the first 3 weeks. The infusion therapy was terminated prematurely in 4 patients because of near normalization of hearing (maximum dosage: 15 g Complamin). Adverse reactions only occurred during the infusion therapy. For ethical and therapeutic reasons a placebo control group was not included. To compensate for this the audiograms of impaired and 'normal' ears were compared. The changes in hearing and tinnitus are therefore to be regarded as the result of spontaneous remission and drug efficacy.     

高压氧配合西药治疗突发性聋疗效分析

目的探讨高压氧配合西药治疗突发性聋的疗效.方法用高压氧配合西药治疗突发性聋41例、44耳,并与单纯应用西药治疗42例、46耳比较.结果高压氧组总有效率为81.82%,单纯西药治疗组总有效率为54.35%.结论高压氧配合西药治疗突发性聋,听力恢复快,效果明显优于单纯西药治疗.     

突聋病人血液流变学及血脂代谢研究

目的探讨血液流变学和血清脂质代谢变化与突发性耳聋(突聋)的关系。方法检测50例突聋病人及50例对照者血液流变学参数及血清中甘油三酯(TG)、总胆固醇(CHO)、高密度脂蛋白胆固醇(HDL-CH)、低密度脂蛋白胆固醇(LDL-CH)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)和脂蛋白(a)[LP(a)]的含量。结果突聋组全血比粘度、全血还原比粘度、血浆粘度和红细胞压积均增高,与对照组比较差异有显著性(P<0.01);突聋组TG、LDL-CH、ApoB和LP(a)水平较对照组显著增高(P<0.01),HDL-CH较对照组显著降低(P<0.01)。两组间CHO和ApoA无显著性差异(P>0.05)。结论 血液流变学及血脂代谢的异常改变可能与突聋的发生相关。     

突聋伴眩晕患者前庭诱发肌源性电位的临床研究

目的通过观察突发性聋伴眩晕患者前庭诱发肌源性电位的引出率及各参数,探讨前庭诱发肌源性电位对突聋伴眩晕患者内耳损伤情况的诊断及预后评估。方法收集50例单耳突聋伴眩晕的患者,50例单耳突聋不伴眩晕患者及60例正常听力人作为对照组,分析对比o VEMP及c VEMP的引出率和各参数变化。结果引出率:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组o VEMP引出率分别为24%、42%、48%、100%,c VEMP引出率分别为:56%、74%、64%、100%,病例组患耳和对侧耳相比,o VEMP及c VEMP引出率差异无统计学意义(P>0.05),病例组患耳及对侧耳分别和正常对照组比较,o VEMP及c VEMP引出率均明显降低(P<0.05),病例组患耳o VEMP引出率明显低于突聋不伴眩晕组(P<0.05)。o VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数(N1潜伏期、P1潜伏期、P1-N1振幅)两两比较,组间不对称比(AR)比较,差异均无统计学意义(P均>0.05)。c VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数比较,患耳及对侧耳P1-N1振幅比突聋不伴眩晕组及正常对照组均明显降低(P<0.05),病例组AR比正常对照组明显增高(P<0.05),o VEMP及c VEMP结果与听力损失分型、听力损失程度分级无明显相关性(P>0.05),但与疗效分级明显相关(P<0.05)。结论突聋伴眩晕患者存在同侧及对侧的椭圆囊(前庭上神经)和球囊(前庭下神经)传导功能障碍,前庭诱发肌源性电位为突聋伴眩晕患者耳石器及前庭神经功能评估提供客观依据。     

229例突发性聋患者的治疗及疗效分析

突发性聋为耳科常见急症,临床表现以突发性听力下降为主,可伴有耳鸣、耳内闷塞感、眩晕等耳蜗及前庭症状或体征。多数单耳发病,极少数为双耳发病。发病机制尚不明确,目前主要应用改善内耳微循环、神经营养、抗凝药物、糖皮质激素、高压     

突发性聋患者血清同型半胱氨酸水平测定临床意义的探讨

目的 :探讨血清同型半胱氨酸水平与突发性聋发病的关系。方法 :收集突发性聋病人 31例 (32耳 ) ,男 16例 ,女 15例 ,年龄 18～ 70岁 ,用荧光偏振免疫发光法检测同型半胱氨酸水平 ,用氧消耗速率法、CHO氧化酶法、GPO- POD紫外光吸收试验法分别测定病人血清的血糖、胆固醇及甘油三脂含量。设 2 3例健康体检者为对照组 ,男 14人 ,女 9人 ,年龄 38～ 6 0岁 ,同法测定血清同型半胱氨酸、血糖、胆固醇及甘油三脂。结果 :突发性聋病人血清同型半胱氨酸水平(2 0 .6 6± 11.31μmol/ L)明显高于对照组 (11.30± 2 .6 0 μmol/ L) P <0 .0 5。血清中血糖、胆固醇及甘油三脂水平在两组间无明显差异。结论 :血清中同型半胱氨酸含量增高可能是突发性聋的独立危险发病因素之一。     

Prospective study of the cardiovascular risk of patients with sudden deafness]

In this prospective case control study 135 patients with sudden hearing loss were compared with regard to their cardiovascular risk with 135 otologically healthy patients and 111 patients with coronary heart disease. The groups were matched according to age, sex and date of onset of disease. The risk factors investigated were: serum cholesterol, low-density lipoproteins, high-density lipoproteins, triglycerides, blood pressure, body weight, diabetes mellitus, positive family history of coronary heart disease and smoking habits. There was no significant difference between the patients with sudden hearing loss and otologically healthy patients. However, the difference between these two groups of patients and the patients with coronary heart disease was very pronounced. The groups of patients with a low frequency, high frequency or pantonal hearing loss did not differ with respect to the distribution of coronary risk factors. Furthermore, no statistical correlation was found between the degree of recovery of hearing function after sudden hearing loss and coronary risk factors.