不同疗法治疗突发性耳聋的疗效及影响因素(英)  

Effect and influence factors on sudden deafness by different treatments

作　　者：姬长友[1] 刘蓉蓉[1] 周定蓉[1] 张民[1] 甘永莲[1] 何凌汉[1] 

机构地区：[1]解放军第三军医大学大坪医院耳鼻咽喉-头颈外科,重庆市400042

出　　处：《中国临床康复》2003年第32期4352-4353,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨不同药物及/或方法组合对突发性耳聋(suddendeafness,SD)患者的疗效及其影响因素。方法:84例(89耳)SD患者分为3组。I组24例(28耳)用脑血管扩张剂、降低血液粘滞度及内耳神经结构保护药物,II组33例(34耳),在上述药物基础上加极化液。I,II组用静脉通道给药,并用高压氧(HBO)。III组27例(27耳),全部用尼莫地平或氟桂利嗪口服,丹参制剂肌肉注射或口服,并用神经结构保护剂,不用HBO。结果:3组有效率依次为67.86%,64.71%,70.37%,χ2检验差异不显著;不同听力曲线对疗效有影响,低频型有效率为84.6%,高频型有效率为44.4%;于发病7d内治疗的病例最有效,痊愈及显效率为77.8%及94.7%,1个月以后少数病例有效;治疗15d总有效率为50.8%,至30d已达84.7%。结论:3组患者用不同药物及/或不同方法组合,疗效差异不明显,应以用改善内耳微循环、降低血液粘滞度、保护内耳神经结构的药物为主;HBO、极化液并不一定能提高疗效;对SD宜早期治疗,发病7天内疗效最好,疗程以15～30d为宜。AIM: To study the curative effect of different treatments and influence factors on sudden deafness(SD). METHODS: Eighty four cases(89 ears)were divided into three groups: group I, group II and group III had 24 cases(28 ears),33 cases(34 ears)and 27 cases(27 ears)respectively.Group I was treated with vasodilating medicines, reducing blood viscosity agent and neurotrophic agent for inner ear, group II was added polarized liquid.The intravenous drip method of medicines and hyperbaric oxygenation(HBO)was used in group I and II.Nimodipine or flunarizine was given by oral administration.Red sage root injection was given through muscle and HBO was not used in group III. RESULTS: The effective rate of the three groups was 67.8%, 64.7%and 70.4%respectively. The difference of Chi squwere test was not significant. The type of acoustic curve was the most important factor for curative effect with that of low frequency type being the highest(84.6%)and high frequency type the lowest (44.4%). The best effect could be obtained if the treatment began within 7 days after the deafness.The auditory threshold became steady 15 days after treatment in the majority of patients and the curative effect rate was 50.8%and 84.7%respectively.The audition was improved 30 days after treatment in a few patients. CONCLUSION:Difference of the curative effect has no significance in three groups of SD patients.Improving microcirculation of inner ear, reducing blood viscosity, and offering neurotrophic agent for inner ear are the principal treatments.HBO and polarized liquid therapy do not increase the curative effect.The most curative effect is obtained when patients received treatment within 7 days, and 15 to 30 days is the appropriate course of SD.

关 键 词：治疗 突发性耳聋 SD 药物 高压氧 血液粘滞度 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]