突发性感音神经性耳聋患者精神心理状态分析  

Mental State in Patients with Sudden Sensorineural Hearing Loss

作　　者：蒋吴限 肖其珍 王立宇[1] 刘淑云 殷泽登 JIANG Wuxian;XIAO Qizhen;WANG Liyu;LIU Shuyun;YIN Zedeng(Department of Otorhinolaryngology Head and Neck Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院耳鼻咽喉头颈外科,泸州646000 [2]简阳市人民医院耳鼻咽喉头颈外科

出　　处：《中华耳科学杂志》2024年第2期216-220,共5页Chinese Journal of Otology

基　　金：四川省自然科学基金(2023NSFSC1448);泸州市人民政府西南医科大学科技战略合作项目(2021LZXNYD-J30);四川省干部保健科研课题(川干研2019-1501)。

摘　　要：目的 探讨不同分型、预后、年龄和职业的突发性感音神经性耳聋(sudden sensorineural hearing loss,SSNHL)患者精神心理状态的差异。方法 采用横断面研究,选取2018年2月—2019年1月简阳市人民医院耳鼻咽喉头颈外科SSNHL住院患者115例,按照职业将患者分为脑力组(医生、公务员、白领、学生、公关、教师、程序员等)59例和体力组56例;按照SSNHL分型将患者分为低频型组35例,平坦型组38例,高频型组17例,全聋型组25例;根据治疗效果分为痊愈组44例,显效组4例,有效组19例,无效组48例。采用症状自评量表调查评估患者治疗前后精神心理状态的变化情况,分析不同分型、预后、年龄及职业SSNHL患者的精神心理状态的差异。结果 不同分型SSNHL患者总均分、抑郁因子、其他因子比较,差异均有统计学意义(P<0.05);不同疗效组恐惧评分比较,差异有统计学意义(P<0.05);脑力组焦虑、偏执分值高于体力组,差异有统计学意义(P<0.05),体力组躯体化分值高于脑力组,差异有统计学意义(P<0.05);不同年龄组10个因子、总均分比较,差异无统计学意义(P>0.05)。结论 SSNHL患者普遍存在失眠、抑郁等消极情绪;全聋与无效组患者在精神及心理方面的问题更为突出,体力劳动者和脑力劳动者不良精神心理问题存在差异。Objective To report mental state in SSNHL patients in relation to hearing loss type,treatment outcomes,age and occupation.Methods In a cross-sectional study,patients with SSNHL treated at the Department of Otolaryngology,Head and Neck Surgery of Jianyang People's Hospital from February 2018 to January 2019(n=115)were divided into a white collar group(n=59)and a blue collar group(n=56).Based on audiometric patterns,patients were grouped as low-frequency descending(n=35),flat descending(n=38),high-frequency descending(n=17),and total deafness(n=25).Based on treatment outcomes,patients were grouped as complete recovery(n=44),significantly improvement(n=4),improved(n=19)and no change(n=48).Mental state was evaluated using the Symptom Checklist-90 before and after treatment,and its correlation with hearing loss types,treatment outcomes,age and occupation were analyzed.Results The total score,depression score and other factors were different in patients with different hearing loss types(P<0.05),while the phobic score was different in patients with different treatment outcomes(P<0.05).Anxiety and paranoidal ideation scores were higher in white-collar workers(P<0.05),while the somatization score was higher in blue-collar workers(P<0.05).The total score,as well as 10 factors,showed no difference in relation to age(P>0.05).Conclusion Insomnia,depression and other negative emotions are common in patients with SSNHL.Mental and emotional problems are worse in patients with total deafness and poor treatment outcomes,and demonstrate differences between white-and blue-collar workers.

关 键 词：突发性感音神经性聋 精神状态 职业 分型 预后 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]