突发性聋的预后与影响因素分析

目的:分析突发性聋的预后与常见影响因素的关系,为判断预后提供参考。方法:回顾性分析124例突发性聋患者的病历。治疗方法包括:改善微循环药物、皮质类固醇激素、神经营养类药物、高压氧治疗。对于伴有感染、高血压、糖尿病等疾病的患者,积极治疗相关疾病。疗程2～4周。统计相关影响因素包括:年龄、发病至初诊时间、听力损失程度、听力曲线类型、是否伴有眩晕与耳鸣等与疗效的关系。结果:痊愈30例,显效48例,痊愈率为24.19%,痊愈、显效率为62.90%。年龄<60岁各组与61～75岁组的疗效存在显著性差异(均P<0.01)。病程<7d、7～14d、>14d的3组疗效比较均差异显著(均P<0.05)。初诊听力损失轻、中度与重、极重度疗效差异显著(P<0.05)。初诊听力曲线上升型、平坦型与下降型的有效率比较存在显著性差异(P<0.05);不伴耳鸣或(和)眩晕的患者治疗有效率显著高于伴耳鸣或(和)眩晕的患者(P<0.01)。结论:>60岁突发性聋患者的疗效显著下降;发病后初诊时间越早疗效越好;发病>14d就诊疗效明显不佳;初诊听力曲线为平坦型和上升型、不伴耳鸣或(和)眩晕的患者预后好。

Analysis on prognostic factors of sudden hearing loss

Objective:To analyse the relationship between common influence factors and the prognosis of sudden hearing loss(SHL)and to predict the prognosis of patient with SHL.Methods:We retrospectively analysed the clinical data of 124 patients with SHL in Department of Otolaryngology of Beijing Haidian Hospital during 2008 to 2011.Treatment method included vasodilators,steroid,neural nutritional medication,hyperbaric oxygen therapy.For the patients with infection,hypertension,diabetes mellitus,the original diseases were treated.Treatment period was 2 to 4 weeks.Clinical influence factors included age,initial diagnosis time,vertigo with(or)tinnitus,degree of hearing loss,the type of audiogram.The factors and curative effect were discussed.Results:Thirty patients were cured and 48 patients were improved.The cure rate was 24.19% and the recovery rate was 62.90%.Curative effect had significant difference between groups with age 61 to 75 and all groups with age lower than 60(P<0.01).The groups with the course of disease lower than 7 days,7-14 days,more than 14 days had significant difference(P<0.05).Comparison with the degree of hearing loss mild or moderate and severe or very severe curative effect proved significant difference(P<0.05).The group with rising or flat audiogram and the group with falling audiogram,the former had better effect(P<0.05).Compared with the patients suffering from vertigo or(and)tinnitus,patients without the obtained an obvious good result(P<0.01).Conclusion:With the increasing of age,especially after 40 years old curative effect was getting worse.The earlier the diagnosis was made,the better the hearing recovered.More than 14 days after the treatment,curative effect was not good.The patients whose type of hearing curves were flat and rising,without tinnitus with(or)vertigo indicated good prognosis.