爆震性耳聋预后与DPOAE特征相关性分析  

DPOAE Characteristics and Prognosis of Blast Induced Deafness

作　　者：姚慧敏 郭子雯 王华[1] 范佳 田茂兰 陈浩峰 苏钰[3] 冀飞[3] 江文[1] YAO Huimin;GUO Ziwen;WANG Hua;FAN Jia;TIAN Maolan;CHEN Haofeng;SU Yu;JI Fei;JIANG Wen(Department of Otolaryngology,Second Affiliated Hospital of Hunan Normal University,921st Hospital of Chinese People's Liberation Army,Changsha 410003;Department of Child Health Care,Hunan Provincial Maternal and Child Health Care Hospital;College of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital)

机构地区：[1]湖南师范大学附属第二医院(中国人民解放军联勤保障部队第921医院耳鼻咽喉科),长沙410003 [2]湖南省妇幼保健院儿童保健科 [3]中国人民解放军总医院耳鼻咽喉头颈外科医学部

出　　处：《中华耳科学杂志》2021年第3期462-467,共6页Chinese Journal of Otology

基　　金：军委后勤保障部保健课题(项目编号:20BJZ22);国家重点研发计划“主动健康和老龄化科技应对”专项(项目编号:2020YFC2005200);湖南省残联课题(项目编号:2020XK035);湖南省教育厅课题(项目编号:20A307,20C1169);。

摘　　要：目的研究爆震性耳聋预后相关因素,为判断疾病预后提供理论依据。方法回顾性分析52例爆震性耳聋患者年龄、病程、纯音测听、耳声发射检查结果等临床资料,按照疗效分为痊愈、有效、无效三组,分析其临床资料特征与预后之间相关性;再根据患者病程分为≤7天组和>7天组,比较不同病程患者的疗效与纯音听阈之间相关性。结果本研究52例爆震性耳聋患者中,三组不同患者疗效与年龄分布和病程之间有统计学差异(Fisher,P<0.05);在4.0、6.0、8.0 kHz处其DPOAE幅值(H值分别为7.358、9.142和9.433)和SNR(H值分别为7.084、11.379和11.813)组间差异有统计学意义(P<0.05);≤7天组患者预后与8.0 kHz处听阈存在相关性(F=4.010,P=0.032)。结论爆震性耳聋患者疗效可根据年龄、病程、急性期高频听阈及DPOAE结果进行预判。受累频段外毛细胞功能越好者听力恢复情况越好,发病后及时就诊、早期系统治疗是预后的积极因素。Objective To identify factors that may affect prognosis of blast induced deafness.Methods Clinical data of 52 patients with blast induced deafness were reviewed,including age,course of disease,pure tone audiometry and otoacoustic emission examination.The patients were divided into three groups based on treatment outcomes:complete resolution,improvement and no change.Correlation between clinical characteristics and treatment outcomes was analyzed.Pure tone audiometry was also compared between patients with course of disease≤7 days and those with course of disease>7 days.Results Among the 52 patients,age and course of disease were correlated with different treatment outcomes(Fisher,P<0.05).DPOAE levels(H=7.358,9.142 and 9.433,respectively)and signal to noise ratios(H=7.084,11.379 and 11.813,respectively)at 4,6 and 8 kHz showed statistically significant differences in relation to treatment outcomes(P<0.05).Hearing threshold at 8.0 kHz was correlated with treatment outcomes in patients with disease course≤7 days(F=4.010,P=0.032).Conclusion Prognosis can be predicted based on age,course of disease and DPOAE results in patients with blast induced deafness.Patients with better preserved outer hair cell function in high-frequency range may have better hearing improvement.Early treatment may lead to favorable prognosis.

关 键 词：爆震性耳聋 畸变产物耳声发射 病程 预后 临床特征 

分 类 号：R764[医药卫生—耳鼻咽喉科]