双耳先后发病突发性聋患者的临床特点分析

目的分析双耳先后发病突发性聋(突聋)患者的临床特点,提出可能的针对性预防措施。方法回顾性分析2015年12月至2018年3月收治的19例双耳先后发病(间隔时间>3 d)突聋患者的临床资料,包括性别、年龄、既往史、患耳侧别、听阈曲线类型、听力损失程度、发病时间、双耳发病的间隔时间及治疗效果,总结其临床特点,并与同期收治的单侧突聋患者比较。结果 19例双耳先后发病的突聋患者中,先发耳听阈曲线为全聋型10例(52.6%)、平坦型8例(42.1%)、高频下降型1例(5.3%),听力下降以重度和极重度聋为主;后发耳听阈曲线为平坦型15例(78.9%)、全聋型3例(15.8%)、低频下降型1例(5.3%),听力下降以中度和重度聋为主。双耳先后发病组平均年龄高于单侧发病组,治疗后有效率低于单侧发病组(P<0.05)。有高血压、糖尿病等慢性病史组出现对侧突聋的比例(56.5%,13/23)高于无慢性病史组(2.8%,6/214)(P<0.05)。结论先发耳听阈曲线为平坦型或全聋型者、听力损失程度为重度或极重度者,且有高脂血症、高血压、糖尿病等影响血流动力学的慢性疾病史的高龄单侧突聋患者,对侧耳再发突聋的可能性较大;降脂、降压、控制血糖等治疗可能有利于预防对侧耳再发突聋。

Analysis of Clinical Characteristics of Sequential Bilateral Sudden Sensorineural Hearing Loss

Objective To study the clinical characteristics of patients with sequential bilateral sudden sensorineural hearing loss(Se-BSSNHL), and to propose possible preventive measures. Methods A retrospective study was carried on 19 patients with Se-BSSNHL in our department from Dec.2015 to Mar. 2018. The information included gender, age, side, medical history, type of hearing loss, time for the treatment, prognosis and so on. A data analysis was performed by using SPSS 23.0, taking P<0.05 as statistically significant difference. Results In the Se-BSSNHL group, 8 patients had flat hearing loss, 10 total deafness and 1 high-frequency hearing loss with severe or profound deafness mostly. There were 15,3, and 1 cases of the above 3 types of hearing loss of the opposite side respectively, with moderate to profound deafness. Patients in Se-BSSNHL group were older and had worse prognosis than those in USSNHL group(P<0.05). When dividing all the patients into group with chronic diseases and group without chronic diseases, like diabetes and hypertension, the ratio of having Se-BSSNHL of group with chronic diseases was higher than that of the other group(P<0.05). Patients in the Se-BSSNHL group were older and more likely to have chronic diseases than those in the USSNHL group, but with worse prognosis than latter. Conclusion The elderly patients whose ear threshold curve is flat or total deafness, with severe or extremely severe hearing loss and the history of chronic diseases such as hyperlipidemia, hypertension and diabetes, are more likely to have sudden deafness in the contralateral ear. Treatments on hypertension, diabetes and hyperlipemia are possibly effective as preventive measures of Se-BSSNHL.