花粉高峰期突发性聋的发病及疗效分析

本文对２０００年第一、二、三、四季度各季度的耳疾总数、 突发性聋的发病总数作回顾性统计，探讨其发病与季节的关 系，并对第三季度突聋患者的治疗特点进行临床分析，研究 其与变态反应的关系，现报告如下。 １资料和方法 １．１临床资料：２０００年第一季度耳疾总数为１７８２耳次，其 中突聋为４３耳次，占耳疾总数的２．４１％。第二季度耳疾总 数为１９７６耳次，其中突聋为３８耳次，占耳疫总数的１．９２％。 第三季度耳疾总数为２６１９耳次，其中突聋为１１４耳次，约占 耳疾总数的４．３５％。第四季度耳疾总数为２３８２耳次…     

老年突发性聋患者临床特征及治疗效果分析

目的：分析老年突发性聋患者的临床特征及治疗效果。方法回顾性分析2013年9月至2015年3月经郑州大学第一附属医院耳科确诊并治疗的66例老年单耳突发性聋患者（年龄60～83岁,老年组）的临床资料,另选择同期住院治疗的291例中青年单耳突发性聋患者（年龄19～59岁）为对照组,比较两组患者的临床特征及治疗效果。结果老年组听阈曲线为低频下降型者占1．51％,低于对照组（14．43％,P＝0．004）;高频下降型（22．73％）和全聋型（50．0％）高于对照组（分别为15．46％、39．52％）;老年组中伴随全身疾病（高血压、糖尿病等,60．61％）及对侧耳存在听力损失（57．58％）的患者所占比例较对照组（分别为17．53％、19．93％）高（ P＜0．05）。两组患者总有效率为70．03％,老年组与对照组的总有效率分别为60．61％、72．16％,差异无统计学意义（ P＞0．05）,老年组痊愈率仅为10．61％,明显低于对照组（29．21％）（ P＜0．05）。结论老年突聋患者多伴有高血压、糖尿病等全身疾病或者发病前患耳可能存在不同程度听力损失;突聋耳听力损失更易发生在高频或全频,治疗总有效率与中青年组相似,但痊愈率较低。     

突聋伴或不伴眩晕对听力的影响

调查1972～1990年就诊单侧突聋1313例，初诊及突聋发病后2个月分别测听力。将两次听力、年龄、性别、有无眩晕症状及治疗方法输入计算机综合分析。听力曲线分5型：高频听力损失、低频听力损失、平坦型、重度聋及其它。1313例中392例（29．2％）伴眩晕，915例（69．7％）无眩晕，6例情况不明。年龄6～79岁，平均39．7士14．4岁。眩晕组平均38．0士14．8岁；无眩晕组平均40．4士14．1岁，两组差异显著（P＜o．OI）。听力图分析；重度聋组及高频听力损失组伴眩晕者分别占全组的69．2％及43．3％。年龄小于14岁，重度聋及高频听力损失组占比例…     

突发性聋伴良性阵发性位置性眩晕患者的预后研究

目的：研究突发性聋（突聋）伴良性阵发性位置性眩晕（BPPV）患者的预后情况。方法：分析24例突聋伴BPPV患者的临床资料,并与同期125例突聋不伴BPPV患者进行比较。结果：突聋伴BPPV和突聋不伴BPPV患者治疗后3个月听力恢复的总有效率分别为41．67％和72．80％,差异有统计学意义（P〈O．05）。结论：突聋伴BPPV患者听力的预后比突聋不伴BPPV患者更差,BPPV是突聋患者听力预后不良的一个影响因素。     

缺铁性聋的诊断与治疗

作者首次将缺铁为直接病因的感音神经性聋命名为缺铁性聋。报告１０２例缺铁性聋的机体铁代谢变化特征和诊治经验。研究结果：（１）缺铁性聋患者的血红蛋白降低，达到公认的贫血标准，血清铁蛋白、红细胞碱性铁蛋白和血清铁含量显著低于正常听力健康人，血清铁日波动差值变小、消失或倒置；（２）铁剂疗法治疗该病的有效、显效和痊愈率分别为７６．５７％、５８．８６％和３５．４３％；（３）缺铁性聋可被分为急性型和慢性型，两型合计的发病率约占全部感音神经性聋的１０～１５％，多见于学龄前儿童、月经期妇女及老年人；（４）提出了本病的诊断标准与治疗原则。本文研究结果为临床耳聋防治与铁缺乏防治提供了新的可靠依据。     

蝮蛇抗栓酶治疗突发性聋的疗效观察

突发性聋为突然发生的原因不明的感音神经性听力损失。我科于１９９６年～１９９８年应用蝮蛇抗栓酶（大连司威特制药有限公司）治疗突聋４２例,取得了良好的疗效。现报告如下。１ 对象与方法１．１ 临床资料 经确诊为突聋的住院患者,随机分为蝮蛇抗栓酶治疗组（简称治疗组）、常规扩血管治疗组（简称对照组）。治疗组４２例,男２９例（３２耳）,女１３例（１５耳）;年龄２４～６４岁,平均４２．４岁;病程２～２４天,平均１０．８天;病前有轻度上呼吸道感染症状者６例,耳聋伴眩晕者１０例,纯音听阈测定以 ５个频率（０．２５、０…     

儿童眩晕症41例分析

目的：总结儿童眩晕症的病因及位、听功能检查结果。方法：自１９８７～１９９６年，共诊治４１例儿童眩晕症患者，男２７例，女１４例，年龄６～１３岁，均进行了纯音测听、声导抗、听［性］脑干反应（ＡＢＲ）和眼震电图描记［法］（ＥＮＧ）检查。结果：前庭末梢性病变２６例（６３．４％），前庭中枢性病变１５例（３６．６％）。其中儿童良性阵发性眩晕、癫痫性眩晕、感音神经性聋、突聋及梅尼埃病分别占１９．５％、１９．５％、１７．１％、９．８％、９．８％。结论：明确诊断儿童眩晕症需全面的位听功能检查、其他相关科室的诊治和临床综合分析     

鼻咽癌放疗后突发感音神经性聋14例临床分析

目的 探讨鼻咽癌放射治疗后突发感音神经性聋患者的临床特点及疗效,以利临床诊治。方法 回顾性分析14例（15耳）鼻咽癌放疗后突发感音神经性聋患者的临床特点及疗效。结果 鼻咽癌放射治疗后突发感音神经性聋的患者中男10例、女4例,左耳10耳、右耳5耳,平均发生时间为放疗后6.6年,突聋前多存在听力损失。250、500、1000、2000、4000 Hz的平均听阈（听力级）：突聋耳为(78.5±24.7) dB,非突聋耳为(57.0±32.4) dB。突聋耳73.33％ (11/15)为感音神经性聋,26.67％为混合性聋(4/15)。12例合并放疗后并发症,至少1例存在后循环障碍。治疗总有效率为26.67％ (4/15),其中4例复发且再治疗无效。结论 鼻咽癌放疗后患者发生突发感音神经性聋的程度较重,疗效较差,易复发。其发病机制可能与放疗所致后循环障碍有关。     

体外反搏联合丹参治疗突聋与血液流变学的研究

本文应用体外反搏联合复方丹参注射液等药物治疗突聋30例（32）耳，同时检测突聋患者治疗前后血液流变学，结果经治疗后，全血比粘度，血小板聚集率等明显下降（P＜0．05或P＜0．01），而听力恢复正常或提高。治疗组总有效率为87．5％，对照组为66．67％。两组疗效差异有显著性（P＜0．05）。因此提示体外反搏联合复方丹参注射液，对突聋具有显著性疗效。本文对体外反搏治疗突聋的机理及疗效和突聋的发病机理进行了探讨。     

耳蜗电图的发现:梅尼埃病与突发性感音神经性聋

对215名病人和117名突聋病人进行ECoChG检查，分析两组的电生理变化以探讨二者的发病机理。检测指标包括总和电位（SP）／动作电位（AP）值、听力曲线及治疗后的听力变化。结果发现：①组病人和突聋组病人中分别有用％和76％的病人SP值大于正常平均值；若以ZSD（标准差）为标准，两组分别有64．4％和36．8％的病人SP值超过正常平均值；若以3SD为标准，则分别有46．6％和23．2％超过正常平均值，②两组病人中SP／AP比率与听力曲线有关。若不考虑听力曲线类型，组SP／AP平均值高于突聋组。在突袭组，上升型和平坦型听力曲线病人中的…     

Bilateral simultaneous sudden deafness--a report of five cases

Five cases of bilateral simultaneous sudden deafness were reported. Two patients were male and three patients were female. The age of the patients ranged from five to 54 years. All the five cases were profoundly deaf on both sides. The elevation of the mumps virus antibody titer was found in the three cases out of four in those examined. The recovery pattern of hearing was seen symmetrically on both sides in four cases. Although complete recovery of hearing was obtained in one case and remarkable improvement was observed in two cases bilaterally, no improvement was seen in one case on either side. The last case showed remarkable improvement of hearing on one side with only a slight recovery on the other. Although the prognosis of the five cases of bilateral simultaneous sudden deafness was found comparable to that of the unilateral case by other investigators, the recovery was slower and the prognosis was less favorable in cases with the elevation of mumps antibody titer.     

A comparative study of mumps deafness and idiopathic profound sudden deafness

We performed a 10-year comparative study on 95 cases (98 ears) of mumps deafness and 97 cases (97 ears) of profound sudden deafness and found the following results. The age of onset of deafness was less than 9 years in the majority of patients with mumps deafness, while it was frequently 30-50 years in those patients with sudden deafness. Among these latter patients, no cases occurred under 9 years of age. The incidence of tinnitus and vestibular symptoms was more frequent in the patients with sudden deafness, but no significant difference was noted in cases over 10 years of age. When determining prognosis, no cases of hearing improvement were encountered in mumps deafness, while about 70% of sudden deafness showed improvement.     

Prediction of prognosis in sudden deafness

Factors influencing the prognosis of sudden deafness were studied in 70 cases. Clinical data were analyzed and three important factors have been found: 1. Among various factors concerning the prognosis, the most important one was the presence of 8 kHz hearing. If hearing in the 8 kHz level could be obtained, prognosis would be better; 2. The time between the onset of deafness and the initial examination was found to be in close relationship with the prognosis, i.e. the sooner the patient seeks for treatment, the better would be the result; 3. The rapidity of the development of deafness was closely related to the prognosis. The faster the development of deafness, the worse would be the prognosis. An optimal regression equation for predicting prognosis has been established. According to this equation, otologists would be able to estimate the prognosis of the patients suffering from sudden deafness.     

A comparative study of mumps deafness and idiopathic profound sudden deafness

Summary We performed a 10-year comparative study on 95 cases (98 ears) of mumps deafness and 97 cases (97 ears) of profound sudden deafness and found the following results. The age of onset of deafness was less than 9 years in the majority of patients with mumps deafness, while it was frequently 30–50 years in those patients with sudden deafness. Among these latter patients, no cases occurred under 9 years of age. The incidence of tinnitus and vestibular symptoms was more frequent in the patients with sudden deafness, but no significant difference was noted in cases over 10 years of age. When determining prognosis, no cases of hearing improvement were encountered in mumps deafness, while about 70% of sudden deafness showed improvement.     

青少年突发性耳聋预后相关因素分析

目的探讨青少年突发性耳聋的临床特点、疗效及预后。方法选取65例青少年突发性耳聋病例作为研究对象,根据患者性别、患侧耳、发病季节、听力图形、听力下降程度、就诊时间、有无伴眩晕、耳鸣、吸烟饮酒史等进行分组,所得数据采用单因素秩和检验,分别比较各组治疗有效率的差异,并用logistic多元回归分析法评价各相关因素对预后的影响。结果治疗后总有效率为58.5%;单因素分析显示就诊时间、听力下降程度、有无伴眩晕等因素与预后有关(P<0.05);多因素logistic回归分析中发病至就诊时间、有无伴眩晕与预后有相关性(P<0.0 5)。结论在影响青少年突发性耳聋预后的因素中,眩晕、听力损失程度及就诊时间与预后有关。     

突发性聋耳声发射与预后的关系

目的本文旨在了解突发性聋患者耳声发射的变化与预后的关系. 方法利用GSI-60型及CELESTA-503 型耳声发射检测仪对29例突发性聋的患者进行了畸变产物耳声发射(DPOAE)的测试,并对其进行了治疗和随访. 结果患耳的DPOAE检出率、幅值低于健耳与正常组,检测阈升高.OAE 检出率与预后的相关性检验无显著相关性. 结论突聋患者OAE 呈中重度感音神经性听力下降的改变.OAE检出与否与预后好坏无统计学意义上的相关性.     

高压氧辅助治疗突发性聋的疗效评价

目的：探讨高压氧作为辅助治疗对突发性聋疗效的影响。方法：回顾性分析1997～2004年收治的102例采用高压氧（高压氧组）辅助治疗突发性聋患者的临床资料,并将同期除高压氧外其他治疗内容均相同的134例患者作为对照（对照组）,用SPSS软件单因素分析性别、年龄、病程、患耳侧别、是否伴有眩晕或耳鸣、诱因、疗程、既往另耳听力下降病史及耳聋程度对预后的影响,采用多元Logistic回归分析排除影响因素,分析高压氧对疗效的影响。结果：单因素分析：性别、患耳侧别、是否伴有耳鸣、诱因及疗程对听力恢复无影响;年龄、病程、是否伴有眩晕、既往另耳听力下降病史及耳聋程度对听力恢复有影响。Logistic回归分析：高压氧组的治疗有效率（听阈提高15dB以上）与对照组相比明显提高,差异有统计学意义（P〈0．01）。结论：高压氧辅助治疗突发性聋有一定疗效,病程长于14d、伴有眩晕、既往另耳有听力下降病史及极度聋患者的听力恢复相对较差。     

镫骨肌反射阈存在的突聋患者预后及影响因素

目的 分析镫骨肌反射阈存在的突聋患者的预后情况,探讨其影响因素。方法 回顾性分析2018年1月至2021年12月收治的282例镫骨肌反射阈存在的突聋患者的临床资料,采用Excel进行数据整理,SPSS 26.0对收集的资料进行描述性分析及统计分析,对性别、年龄、就诊时间、是否伴有耳鸣、眩晕、基础疾病(糖尿病、高血压、冠心病)、听力曲线类型、听力损失程度、镫骨肌反射阈、镫骨肌反射阈与纯音听阈差值(A-T)等因素进行统计学分析。结果 282例镫骨肌反射阈存在的突发性聋患者中,治愈101例,显效8例,有效54例,无效119例,总有效率57.8%。耳聋侧别(P=0.907)、伴随症状(P_眩晕=0.686,P_耳鸣=0.534)、基础疾病(P_高血压=0.338,P_糖尿病=0.262,P_心脏病=0.780)、镫骨肌反射阈(P_{0.5 kHz}=0.152,P_{1.0 kHz}=0.701,P_{2.0 kHz}=0.810)、镫骨肌反射阈与...     

Incidence and prognosis of acute profound deafness in Japan

The Acute Profound Deafness Investigation and Research Group of the Japanese Ministry of Health and Welfare conducted nation-wide studies on idiopathic sudden deafness, mumps deafness, and deafness accompanied by perilymphatic leak. In the epidemiological study, data were accumulated from 11 institutions on the incidence and prognosis of patients with idiopathic sudden deafness, especially involving total deafness or near-total deafness; mumps deafness; and deafness accompanied by perilymphatic leak. Out of 1,331 patients with sudden deafness, total deafness was found in 8.6% of the patients, and near-total deafness was found in 10.7% of the patients, with prognosis being less favorable in the former than in the latter. Perilymphatic leak was found in 10(0.7%) of the patients with idiopathic sudden deafness. Among the patients with deafness accompanied by perilymphatic leak, hearing recovery was rated as cured or markedly recovered in 41% of the patients. Hearing recovery was not observed in all the patients with mumps deafness showing total deafness.     

突发性聋临床疗效与相关因素探讨

目的探讨影响突发性聋疗效的相关因素,为突发性聋治疗提供经验。方法回顾性分析137例突发性聋的临床资料。结果突发性聋的预后与性别、是否伴眩晕、是否伴耳鸣、是否伴心脑血管疾病无关,与发病年龄、初诊时间、听力曲线类型、是否伴有精神心理因素有显著相关性。结论年轻患者,初诊时间越早,听力曲线为上升型,无精神心理因素者预后好,反之较差。