部分突聋患者的椎动脉改变  

Part of the vertebral artery in patients with sudden deafness

作　　者：宋翊飒[1] 吕峰泉[2] 蔡辉霞 吴浩 

机构地区：[1]青海省人民医院耳鼻咽喉科,西宁810005 [2]青海省人民医院介入科 [3]青海省地方病预防控治所 [4]青海省交通医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第16期905-907,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析部分突聋患者椎-基底动脉系统DSA的表现特点,以期了解内耳血供的异常状态,为临床治疗提供有针对性的治疗方案。方法:对经彩超证实有椎-基底动脉供血不足的34例突聋患者分别在两侧椎动脉行DSA检查,分析椎动脉、基底动脉、小脑前下动脉、内听动脉的影像学表现,继而有针对性地行耳内科治疗方案,疗程结束后观察听力改善情况。结果:34例均成功进行上述检查,无相关并发症出现。34例中,2例表现一侧椎动脉闭塞,5例椎动脉硬化。分别有29.4%(10/34)的右侧小脑前下动脉和35.3%(12/34)的左侧小脑前下动脉呈现缺失或细小改变,64.7%(22/34)的右侧内听动脉和73.5%(25/34)的左侧内听动脉呈现缺失或细小改变。行针对性的耳内科治疗方案后纯音听阈测试显示听阈水平(250、500、1 000、2 000、4 000Hz听阈的平均值)平均下降28.2dBHL,其中痊愈8例,显效9例,有效12例,无效5例,总有效率85.3%。结论:部分突聋患者的发病与其内听动脉、小脑前下动脉的细小、缺失导致的内耳缺血有相关性。因此,在行耳内科治疗中,合理使用扩张血管的药物对此类突聋患者的疗效是较为令人满意和肯定的。Objective： To explore the characteristics of vertebral artery system in the patients with sudden deafness by using digital subtraction angiography（DSA ）. Method： Thirty-four cases of sudden deafness with verte- brobasilar artery ischemia confirmed by the color dopplar ultrasound were undergone DSA in both side. The char- acteristics of vertebral artery, basal artery and before cerebellum artery were analysised before specific therapy. Result：There is no related complication were occurred among 34 cases. Side vertebral artery was blocked in 2 ca- ses, atherosclerosis was found in 5 cases. The right cerebellar artery anterior and the left cerebellar artery posteri- or were found filling defect or minor change in 29.4%（10/34） and 35.3%（12/34） of the patients, respectively. The right and the left arteria auditiva interna were found filling defect or minor change in 64. 7% （22/34） and 73.5%（25/34） of the patients, respectively. After specific therapy, 8 cases were cured, the hearing of 9 cases were markedly improved, the hearing of 12 cases were improved efficient and 5 patients have no hearing improve- ment, the total effective rate was 85.3%. Concluslon：The arteria auditiva interna and inferior anterior arteria eere- belli casued inner ear ischemia were found in the patients with sudden deafness. The using of vasolidator may have satisfactory and positive curative effect in the therapy of sudden deafness.

关 键 词：听觉丧失 突发性 椎-基底动脉系统 血管造影 临床方案 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]