急性低频感音神经性聋预后相关因素分析  

Analyses of prognostic factors relevant to acute low-tone sensorineurai hearing loss

作　　者：王明明[1] 韩月臣[1] 陈成芳[1] 吕亚峰[1] 侯志强[1] 樊兆民[1] 王海波[1] 

机构地区：[1]山东大学附属省立医院耳鼻咽喉头颈外科,济南250021

出　　处：《中华耳鼻咽喉头颈外科杂志》2016年第9期644-649,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：山东省科技发展计划（2014GSF118109、2012G0021838）;山东省优秀中青年科学家科研奖励基金（BS2012YY028）

摘　　要：目的探讨急性低频感音神经性聋（acute low－tone sensorineural hearing loss, ALHL）患者预后的相关因素。方法196例成人单侧ALHL患者，男82例、女114例，平均年龄（43.1±14.3）岁。均给予相同的治疗方案并观察记录疗效，应用SPSS 18.0软件分析年龄、性别、病程、耳聋分级、前庭功能、耳蜗电图及甲状腺功能等因素对听力预后的影响。结果196例患者中痊愈124例（63.3%），显效5例（2.6%），有效42例（21.4%），无效25例（12.8%），总有效率为87.2%。15例（12.1%）痊愈患者在随访中出现听力波动，其中2例确诊为梅尼埃病。听力无效患者的年龄显著大于其他疗效组，差异具有统计学意义（P〈0.05）。性别对听力疗效分布无统计学影响（P〉0.05）。不同病程组间，总有效率的差异具有统计学意义（P〈0.05）；病程≤14 d、14 d〈病程≤6个月、6个月〈病程≤2年三组患者间治愈率差异具有统计学意义（P值均〈0.05）。不同听力损失程度患者间比较，总有效率的差异无统计学意义（P〉0.05），但治愈率的差异具有统计学意义（P〈0.05），轻度聋组的治愈率明显高于中度和重度聋患者（P值均〈0.05）；轻度聋中病程≤3个月者的治愈率显著高于病程〉3个月者（P〈0.05）；中度聋中病程≤7 d者的治愈率显著高于病程〉1个月者（P〈0.05）。患侧前庭功能异常者130例（66.3%），听力疗效显著差于前庭功能正常的患者（χ^2＝15.1，P〈0.05）。患侧耳蜗电图异常者17例（8.7%），均伴有前庭功能异常，其听力疗效均为无效。甲状腺功能血清学异常者45例（23.0%），显著高于正常人群（5.9%）（χ^2＝7.26，P〈0.01），但甲状腺功能血清学异常对ALHL预后无明显影响（χ^2＝2.51，P〉0.05）。结论ALHL预后与病程密切相关，治愈率与听力损失程度相关，年龄增长、前庭功能和耳蜗电图异常是预后不良ObjectiveTo investigate the prognostic factors relevant to acute low-tone sensorineural hearing loss （ALHL）. Methods196 adult ALHL patients, including 82 males and 114 females with mean age of （43.1±14.3）years old were included. All patients received the same therapy and were evaluated the curative effect. To evaluate the impact factors on the prognosis of hearing, inclusive of age, gender, time delay before the first visit, degree of deafness, vestibular function, electrocochleogram, and the serum levels of thyroxines by SPSS 18.0 software. ResultsOf those 196 patients with ALHL, 124（63.3%） were recovery, 5（2.6%） were excellent better, 42（21.4%） were better, and 25 （12.8%） were poor, with a total effective rate of 87.2%. Among 15 （12.1%） who recurred the hearing loss, 2 developed into Meniere′s disease during the follow-up. The mean age of patients with poor hearing effect was significantly older than that of other patients （P〈0.05）. No relativity was found between gender and hearing curative effect. There existed a statistical difference in total effective rate among subjects with different histories （P〈0.05）. In addition, the recovery rate was significantly different between groups, i. e., the course of disease was less than 14 days, between 14 days and 6 months, and between 6 months and 2 years （P〈0.05）. There was no statistical significance in total effective rate among different degrees of deafness （P〉0.05）. However, in term of the recovery rate, the difference was statistical significance （P〈0.05）. The recovery rate in patients with mild hearing loss was higher than that in middle or heavy hearing loss （both P〈0.05）. Among patients with mild deafness, the recovery rate in patients whose history was less than 3 months was significantly higher than that more than 3 months （P〈0.05）. For moderate deafness patients, the recovery rate in patients whose history was less than 7 days was significantly higher than that more than 1 month （P〈

关 键 词：听觉丧失 感音神经性 预后 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]