高压混合氧对不同听力曲线突发性耳聋患者的干预效果比较  

Interventional effect of mixed hyperbaric oxygen on sudden deafness in patients with different audiometric curves

作　　者：沈庆旗[1] 曹锦泉[2] 李青[1] 徐小凤[1] 

机构地区：[1]江苏大学附属人民医院高压氧科,江苏省镇江市212002 [2]解放军南京军区南京总医院高压氧科,江苏省南京市210002

出　　处：《中国临床康复》2005年第26期42-43,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:比较高压混合氧对电测听不同听力曲线突发性耳聋患者的干预效果。方法:选择1999-02/2003-02经南京军区南京总医院耳鼻喉科诊断为突发性耳聋的患者360例,均知情同意。根据患者在本院检查的电测听结果及就诊时间顺序分为4组,分别为上坡型、下坡型、平坦型及聋型电测听听力曲线组,每组90例。采用三舱七门大型高压氧舱,纯氧管路上安装高压纯氧-二氧化碳混合装置,输入二氧化碳浓度≥常压下3%、其余气体为纯氧的混合氧。压缩空气加压至0.2MPa,戴面罩吸配制好的高压混合氧15min,20min后减压出舱。1次/d,10次为1个疗程,共2个疗程。在高压混合氧治疗的同时,应用扩血管药物。治疗结束后,均在本院复查电测听,观察患者听力改善程度,以语音区频率250Hz,500Hz,1000Hz,2000Hz及4000Hz的平均值进行计算。显效:听力曲线250～4000Hz的听力较治疗前平均提高30dB以上,伴随症状基本消失;有效:听力曲线250～4000Hz的听力较治疗前平均提高15～30dB,伴随症状减轻;无效:听力曲线250～4000Hz的听力较治疗前平均提高<15dB,伴随症状无改善。结果:360例患者全部进入结果分析,无脱落。各组患者的疗效比较:上坡型听力曲线组显著优于下坡型、平坦型及聋型听力曲线组犤94%,86%,84%,80%,(P<0.05)犦,下坡型听力曲线组与平坦型听力曲线组的有效率相似(P>0.05),聋型听力曲线组疗效最差。结论:电测听结果提示,用高压混合氧治疗不同听力曲线类型突发性耳聋,上坡型听力曲线组患者的听力改善效果明显优于下坡型、平坦型及聋型听力曲线组患者。此结果的产生是同一种疾病的发病部位及原因不同所致,从而决定了干预效果的差异性。AIM： To compare the interventional effects of mixed hyperbaric oxygen on sudden deafness in patients with different audiometric curves detected by electroaudiometry. METHODS： From February 1999 to February 2003, 360 patients were diagnosed as sudden deafness in the Department of Otorhinolaryngology, General Hospital of Nanjing Military Area Command, and they were all told and consentient about our study. Then, they were divided into four groups, 90 in each group, according to the results of electroaudiometry and the hospitalization time： assurgent, declivous, aclinic and deaf audiometric curve groups. A large-scale hyperbaric oxygen chamber with 3 cabins and 7 valves was employed, in which pure oxygen passage was equipped with an apparatus containing pure oxygen and carbon dioxide. The concentration of infused carbon dioxide was equal to or higher than 3% of normal pressure, and other gases were all mixed with pure oxygen. When the compressed air was compressed to 0.2 MPa, patients wearing face masks were guided into the cabin to breath the mixed hyperbaric oxygen for 15 minutes, and then they came out of the decompressed cabin 5 minutes later. The above process went on once a day, 10 times as a course for a total of 2 courses. The drugs for vasodilatation were given synchronously. The audiometric curve was re-examined by electroaudiometry in the same hospital to investigate the improvement of patients＇hearing by calculating the mean frequency of 250 Hz, 500 Hz, 1 000 Hz, 2 000 Hz and 4 000 Hz in phone area. The improvement was judged based on the following criteria： it was considered as remarkable effectiveness that the average hearing threshold was increased by over 30 dB after treatment versus before treatment at the hearing frequency between 250 and 4 000 Hz and patients＇concomitant symptoms nearly disappeared, as effectiveness that the average hearing threshold was increased by 15 to 30 dB after treatment versus before treatment at the same hearing frequency as above and patients＇concomitant sy

关 键 词：聋 突发性 高压氧 治疗结果 高压混合氧治疗 听力曲线类型 突发性耳聋 耳聋患者 效果比较 南京军区南京总医院 二氧化碳浓度 

分 类 号：R743.310.5[医药卫生—神经病学与精神病学] R764.437[医药卫生—临床医学]