高压氧联合类固醇治疗特发性突发性感音神经性听力损失的临床疗效及影响因素分析  

Clinical efficacy and influencing factors analysis of hyperbaric oxygen combined with steroids in the treatment of idiopathic sudden sensorineural hearing loss

作　　者：张小英 李娅 王文岚 Zhang Xiaoying;Li Ya;Wang Wenlan(Hyperbaric oxygen department,Shenmu Hospital,Shenmu719300,China;Department of Aerospace Medicine,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]神木市医院高压氧科,神木719300 [2]空军军医大学航空航天医学系,西安710032

出　　处：《中华航海医学与高气压医学杂志》2024年第6期743-746,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：空军军医大学军事医学提升计划项目(2022ZZXM032)。

摘　　要：目的探讨高压氧联合类固醇治疗特发性突发性感音神经性听力损失(特发性突聋)的临床疗效及影响因素。方法选取2021年1月至2023年12月神木市医院高压氧科收治的特发性突聋患者84例作为研究对象,采用随机数字表法分为A、B、C、D组,每组21例。A组患者予以静脉滴注醋酸地塞米松治疗,B组患者予以静脉滴注醋酸地塞米松+高压氧治疗,C组患者予以静脉滴注醋酸地塞米松+鼓室内地塞米松磷酸二钠注入治疗,D组患者予以静脉滴注醋酸地塞米松+鼓室内地塞米松磷酸二钠注入+高压氧治疗。比较各组患者治疗后的临床疗效;对治疗有效组(n=67)与无效组(n=17)特发性突聋患者临床资料进行单因素方差分析。入院采用麦力声纯音电测听仪测定500、1000、2000、4000 Hz的气导听阈值为初始平均纯音听力均值(PTA),治疗14 d后再次测定PTA值,并计算听力增益。结果治疗14 d后,单因素方差分析结果显示,2组患者临床疗效与年龄,发病至开始治疗时间,听力损失程度,糖尿病及合并耳鸣、眩晕、睡眠障碍等症状有关(P<0.05或P<0.01);而与性别、高血压病、高脂血症及是否采用高压氧治疗无关(P>0.05)。当初始PTA值为80~89 dB和>100 dB时,高压氧治疗后患者听力增益比较差异无统计学意义(P>0.05);但初始PTA值为90~99 dB时,高压氧治疗后患者听力增益比较差异有统计学意义(P<0.05或P<0.01)。结论高压氧联合类固醇治疗特发性突聋的临床疗效与单纯类固醇治疗比较差异不明显,但是PTA初始阈值为90~99 dB的特发性突聋患者听力增益明显,可有效提高患者听力。Objective To investigate the clinical efficacy and influencing factors of hyperbaric oxygen combined with steroids in the treatment of idiopathic sudden sensorineural hearing loss(idiopathic sudden deafness).Methods A total of 84 patients with idiopathic sudden deafness admitted to the hyperbaric oxygen department of Shenmu Hospital from January 2021 to December 2023 were selected as the study subjects.They were randomly divided into groups of A,B,C,and D using the random number table method,with 21 patients in each group.Group A received intravenous infusion of dexamethasone acetate,Group B received intravenous infusion of dexamethasone acetate+hyperbaric oxygen therapy,Group C received intravenous infusion of dexamethasone acetate+intratympanic injection of dexamethasone disodium phosphate,and Group D received intravenous infusion of dexamethasone acetate+intratympanic injection of dexamethasone disodium phosphate+hyperbaric oxygen therapy.The clinical efficacies were compared;one-way ANOVA was performed on clinical data of idiopathic sudden deafness patients in the effective treatment group(n=67)and the ineffective treatment group(n=17).Upon admission,the air-conduction hearing threshold values at 500,1000,2000,and 4000 Hz were measured using a Melison pure-tone audiometer as the initial mean pure-tone audiometry(PTA).Fourteen days after treatment,the PTA value was measured again,and the hearing gain was calculated.Results After 14 days of treatment,the results of one-way ANOVA showed that the clinical efficacy of the patients in the two groups was related to age,the time from onset to the start of treatment,the degree of hearing loss,diabetes,and symptoms such as tinnitus,dizziness,and sleep disorders(P<0.05 or P<0.01);however,it was not related to gender,hypertension,hyperlipidemia,or whether hyperbaric oxygen therapy was used(P>0.05).When the PTA value is between 80-89 dB and>100 dB,there was no statistically significant difference in the hearing gain after hyperbaric oxygen therapy(P>0.05);however,when the

关 键 词：特发性突发性感音神经性听力损失 高压氧 类固醇治疗 临床疗效 影响因素 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]