突发性聋患者耳闷胀感与疗效的相关分析  

Clinical multi-center study on the treatment of sudden sensorineural hearing loss accompanied with feeling of ear fullness

作　　者：王晓丽[1] 刘伟[1] 谢淑敏[1] 任红苗[1] 殷团芳[1] 任基浩[1] 张劲[2] 唐亮[3] 郭小平[2] 陈娟[2] 杨丽[2] 尤乐都斯·克尤木[3] 谭元元[3] 阿不都如苏力·阿不都拉 顾兴智[3] 艾力根[3] 

机构地区：[1]中南大学湘雅二医院耳鼻咽喉头颈外科耳科研究所,长沙41001l [2]新疆维吾尔自治区人民医院耳鼻喉一科 [3]新疆维吾尔自治区人民医院耳鼻喉二科

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第6期458-462,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的探讨突发性聋患者耳闷胀感的发生情况及其与疗效之间的关系。方法采用前瞻性随机临床多中心研究方法，收集年龄18-65周岁，病程2周以内，未经任何相关医疗处理的突发性聋患者，按照听力曲线分为低中频下降型、中高频下降型、平坦下降型和全聋型四种类型。每种类型分别采用四种不同的治疗方案，根据统一设计的随机表，随机选取其中一种方案进行治疗。对四种不同类型听力曲线患者，依据是否伴有耳闷胀感症状，分为伴耳闷耳胀组和不伴耳闷耳胀组，随访4周，对各组疗效进行统计分析。结果2007年8月至2011年10月全国33家医院共收集符合入组条件的单侧突发性聋患者l024例，其中伴有耳闷胀感者565例（55．18％）。低中频下降型205例，伴耳闷耳胀者122例（59．51％）；高中频下降型141例，伴耳闷耳胀者74例（52．48％）；平坦型402例，伴耳闷耳胀者229例（56．97％）；全聋型276例，伴耳闷耳胀者140例（50．72％）。耳闷症状缓解的有效率低中频下降型最高，为100％，平坦型次之，为96．48％，全聋型为92．47％，中高频下降型为90．70％。伴耳闷胀感突聋患者听力恢复的总有效率：低中频下降型最高，为93．44％；平坦型次之，为84．28％；全聋型为75．71％；中高频下降型为70．27％。有耳闷胀感的各型突聋患者的听力恢复总有效率均高于无耳闷耳胀者，但其差异无统计学意义（P值均〉0．05）。结论各型突聋患者耳闷症状的缓解与听力恢复情况基本上是平行的，伴有耳闷者的听力恢复效果可能会略好于不伴耳闷者，但尚需进一步研究。Objective To investigate the therapeutic effect of drug treatment tor patients with sudden sensorineural hearing loss （SSNHL） accompanied with feeling of ear fullness （FEF）. Methods A prospective clinical muhicenter research was carried out from August 2007 to October 2011. SSNHL patients aged between 18 to 65 years old and accepted no medication were recruited, with a duration less than two weeks. The patients were divided into four types according to the hearing curve：type A was acute SSNHL in low tone frequencies, type B was acute SSNHL in high tone frequencies, type C was acute SSNHL in all frequencies, and type D was total deafness. Each type was subdivided into two groups by the accompaniment of SEF or not. And each type had four different treatment programs, based on the unified designed randomized table. All patients were followed up for four weeks from the initial examination. Results A total of 1 024 cases with single side SSNHL were recruited in the study from 33 hospitals in China, including 565 cases accompanied with FEF （ 55. 18% ）, and 459 cases without FEF （44. 82% ）. By classification of audiogram, 205 cases were type A（20. 20% ）, of whom 122 were accompanied with FEF （59. 51% ） ; 141 cases belonged to type B（ 13.77% ） , of whom 74 were accompanied with FEF （52. 48% ） ; 402 cases were type C（39. 25% ）, of whom 229 were accompanied with FEF （56. 97% ） ; and 276 cases were classified as type D （26. 95% ）, of whom 140 were accompanied with FEF （50. 72% ）. No significant difference was observed in total effective rate between the SSNHL patients accompanied with FEF or not in four acoustic types （P 〉 0.05 ）. Among four acoustic types, the clinical cure rate of patients accompanied with FEF in type A was 93.44%, ranking the first; followed by 84. 28% for type C; 75.71% for type D; and 70. 27% for type B, respectively. Conclusions The therapeutic effect for patients accompanied with FEF in type A is satisfactory. The presence of FEF do not impact t

关 键 词：听觉丧失 突发性 耳闷耳胀 测听法 纯音 随机对照试验 药物疗法 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]