突发性聋不同疗法的疗效及影响因素分析  

Analysis of Different Treatments and Influence Factors for Sudden Deafness

作　　者：姬长友[1] 周定蓉[1] 张民[1] 甘永莲[1] 何凌汉[1] 

机构地区：[1]第三军医大学大坪医院耳鼻咽喉-头颈外科,重庆400042

出　　处：《听力学及言语疾病杂志》2002年第3期137-139,共3页Journal of Audiology and Speech Pathology

摘　　要：目的　探讨不同药物及 /或方法组合对突发性聋 (suddendeafness,SD)患者的疗效及其影响因素。方法　 84例 (89耳 )SD患者分为三组。Ⅰ组 2 4例 (2 8耳 )用脑血管扩张剂、降低血液粘滞性及内耳神经结构保护药物 ,Ⅱ组 33例 (34耳 ) ,在上述药物基础上加极化液。Ⅰ、Ⅱ组用静脉通道给药 ,并用高压氧 (HBO)。Ⅲ组 2 7例 (2 7耳 ) ,全部用尼莫地平或氟桂利嗪口服 ,丹参制剂肌肉注射或口服 ,并用神经结构保护剂 ,不用HBO。结果　三组有效率依次为 6 7.86 %、6 4.71%及 70 .37% ,x2 检验差异不明显 ;不同听力曲线对疗效有影响 ,低频型有效率为 84.6 % ,高频型有效率为 44 .4% ;于发病 7d内治疗的病例最有效 ,痊愈及显效率为 77.8%及 94.7% ,但 1个月以后仍有少数病例有效 ;SD的疗程 :治疗 15d总有效率为 5 0 .8% ,至 30d已达 84.7%。结论　三组病人用不同药物及 /或方法组合 ,效疗差异不明显 ,应以用改善内耳微循环 ,降低血液粘滞度 ,保护内耳神经结构的药物为主 ;HBO、极化液并不一定能提高疗效 ;对SD宜早期治疗 ,发病 7d内疗效最好 ,疗程以 15～Objective To study the curative effect of different treatments and influence factors for sudden deafness(SD). Methods 84 cases (89 ears) were divided into three groups:group I had 24 cases (28ears) ,group II 33 cases (34 ears) and group III 27 cases (27 ears). Group I was treated with vasodilating medicines ,reducing blood viscosity agent and neurotrophic agent for inner ear, group II added polarized liquid therapy. The intravenous drip method of medicines and hyperbaric oxygenation (HBO) were used in groups I and II. Nimodipine or flunarizine were given by oral administration, red sage root injection was given through im and HBO was not used in group III.Results The effective rates of treatment in three groups were 67.9%, 64.7% and 70.4% respectively. The difference of Chi-square test was not significant. The type of acoustic curve was the most importante factor for curative effect with low frequency type the highest (84.6%) and high frequency type the lowest (44.4%). The best effect was obtained treatment begun within 7 days after the deafness ,the auditory threshold become steady 15 d after treatment in the majority of patients and curative effect rates were 50.8% and 84.7%, respectively .The audition improved 30 d after treatment in a few patients. Conclusion Different of curative effect was of no significance in three groups of SD patients. The improving microcirculation of inner ear, reducing blood viscosity, neruotrophic agent of inner ear were principal treatments. HBO and polarized liquid therapy did not increase curative effect. Most curative effect was obtained when patients received treatment in 7 d , 15 d to 30 d was appropriative course of treatment of SD.

关 键 词：疗效 影响因素 突发性聋 治疗学 高压氧 极化液 SD 

分 类 号：R764.473[医药卫生—耳鼻咽喉科]