伴有眩晕或头晕的突发性聋患者的临床疗效分析  

Analyses of clinical features and efficacy of sudden deafness with vertigo and dizziness

作　　者：刘博[1] 韩德民[1] 张祎[1] 李永新[1] 龚树生[1] 陈秀吾 孟曦曦[1] 唐俊翔[1] 向杰[1] 姜学钧[2] 杨宁[2] 田颖[2] 惠莲[2] 冯帅[2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心,100730 [2]中国医科大学附属第一医院耳鼻咽喉头颈外科

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第6期463-467,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的探讨伴有眩晕／头晕症状的突发性聋（以下简称突聋）患者的临床特点和药物治疗效果。方法采用前瞻性、随机、单盲法进行临床多中心研究，收集年龄18-65周岁，病程2周以内并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。随访4周，对伴有眩晕／头晕症状的突聋患者的疗效以SPSS13．0软件进行统计分析。结果2007年8月至2011年10月，全国33家医院按标准共纳入符合条件的突发性聋患者1024例，其中296例（28．91％）伴有眩晕／头晕症状，男126例，女170例，平均年龄为（41．2±13．5）岁。在不同听力曲线突聋分型中，全聋型的眩晕／头晕发生率最高（44．93％），往下依次为平坦下降型（25．87％）、中高频下降型（21．28％）和低中频下降型（18．54％）。经规范治疗后，突聋患者所伴发的眩晕／头晕症状基本都能消失，各组听力也均有明显提高。其中伴有眩晕／头晕的低中频下降型患者听力疗效最好，总有效率可达94．74％（痊愈率68．42％）；其次为平坦型，总有效率为80．76％（痊愈率22．12％）；而中高频下降型和全聋型的效果相对较差，总有效率分别为70．00％（痊愈率10．00％）和65．32％（痊愈率5．65％）。各型突发性聋伴有晕与不伴晕患者的听力恢复总有效率差异均无统计学意义（均P〉0．05）；但是不伴眩晕／头晕的全聋型与中高频下降型突聋患者的痊愈率明显高于伴有眩晕／头晕的患者，差异具有统计学意义（均P〈0．05）。结论各型突发性聋均有一定比例的患者伴发眩晕／头晕，尤以全聋型为著。伴有眩晕／头晕的全聋型及中高频下降型突聋患者，Objective To investigate the clinical characteristics and the effect of drug treatment for sudden hearing loss with vertigo or dizziness. Methods In a prospective, randomized, single blinded randomized multicenter clinical study, patients with sudden deafness, ranging in age from 18 to 65 years old, with a duration less than 2 weeks, and with no any medical treatments were collected. In accordance with the hearing curve, those patients were divided into four types, i. e. , low and intermediate frequency descent type; high frequency descent type; fall flat type ; and total deafness type. Each type was treated by four different treatment options, according to the unified design of the random table, and randomly selected one of the options for treatment. The efficacy of the patients with sudden deafness with vertigo and dizziness was analyzed statistically after the follow-up for 4 weeks. SPSS 13.0 software was used to analyze the data. Results In August 2007 to October 2011, 33 hospitals in the country included 1 024 patients with sudden deafness in line with the inclusion criteria, of whom 296 （28.91%） were accompanied by vertigo/dizziness symptoms, 126 were males and 170 were females, with an average age of （41.2 ± 13.5）years old. types of the different audiometric curves of sudden deafness, the occurrence of complete deafness with vertigo/ dizziness was the highest （44.93%） , followed by fiat down type （25.87%）, high frequency descent type （21.28%） and low intermediate frequency descent type （ 18.54% ）. After the standard treatment, the vertigo and dizziness symptoms of the sudden deafness patients could disappear, and the hearing in each group was obviously improved. The hearing curative effect on patients accompanied by vertigo / dizziness of low frequency and intermediate frequency descent type was the best, and the total efficiency can reach up to 94.74%, with the cure rate of 68.42%; followed by fiat type, in which the total effective rate was 80.76% , with the recovery rate of 22.1

关 键 词：听觉丧失 突发性 眩晕 头晕 随机对照试验 药物疗法 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]