不同吸氧方法联合药物治疗突发性聋的对比研究

摘要

目的 对比观察不同吸氧方法联合药物治疗突发性聋(sudden hearing loss,SHL)的疗效,探讨SHL治疗新模式.方法 依据选定的标准,挑选海军总医院2011年2月至2013年8月收治的SHL患者101例,均给予地塞米松磷酸钠注射液、银杏叶提取物注射液等药物治疗.按给氧方式不同分为A、B、C组,A组37例联合0.20 MPa高压氧治疗;B组37例联合0.16 MPa高压氧治疗;C组27例联合0.10 MPa(常压)面罩吸纯氧治疗.A组3例、B组6例治疗期间出现耳闷加重、查鼓室声阻抗为C型曲线,将其调整为低压舱吸氧治疗,压力0.07 MPa(设为D组,共9例).A组剩余34例患者为A1组,B组剩余31例患者为B1组.所有患者均于治疗前、治疗第14天查纯音测听和鼓室声阻抗.结果 A1、B1、C、D组总有效率分别为82.4％、83.9％、59.3％、77.8％.治疗前后平均听阈值分别提高了(43.7±17.4)dB、(46.3±21.2)dB、(28.1±12.3)dB、(41.9±19.8)dB.A1、B1组总有效率与C组比较,差异有统计学意义(P ＜0.05);A1、B1组治疗前后平均听阈提高值高于C组(P＜0.05),D组患者耳闷堵感症状明显减轻.结论 高压氧联合地塞米松磷酸钠注射液、银杏叶提取物注射液是治疗SHL的有效方法.0.16 MPa高压氧疗效满意,经济成本低,更具优势;耳闷堵感症状明显时可调整为0.07 MPa低压舱吸氧治疗.%Objective To compare and observe the clinical effects of different oxygen-breathing methods coupled with drugs in the treatment of sudden hearing loss (SHL),so as to explore new approaches for the treatment of the illness.Methods In accordance with the set criteria,101 cases of sudden hearing loss admitted into the center from Feb.2011 to Aug.2013 were selected for our study.All the patients received injections of dexamethasone sodium phosphate,ginkgo leave extract injection and other drug treatment.Then,the patients were randomly allocated to groups A,B and C in accordance with different methods of oxygenbreathing.Group A (37 cases) received drug treatment coupled with 0.20 MPa hyperbaric oxygen (HBO) therapy; Group B (also 37 cases) received the same drug treatment coupled with 0.16 MPa HBO therapy; and Group C (27 cases) received the same drug treatment coupled with 0.10 MPa (normal pressure) oxygen maskbreathing.During HBO therapy,the feeling of ear stuffiness in 3 patients from group A and 6 patients from group B was worsened and "C curve" of tympanic acoustic impedance was shown,and these 9 cases changed to receive low pressure oxygen breathing at 0.07 MPa,and were assigned as group D.The remaining 34 patients in group A and 31 patients in group B were then respectively assigned as group A1 and group B1.Pure tone audiometry and tympanic acoustic impedance detection were performed in all the patients both before treatment and at d 14 after treatment.Results Total effective rates for groups A1,B1,C and D were 82.4％,83.9％,59.3％ and 77.8％ respectively.Pure tone average (PTA) were respectively increased by (43.7 ± 17.4) dB,(46.3±21.2)dB,(28.1 ± 12.3)dB and (41.9 ± 19.8)dB.When compared with the control group,statistical difference could be seen in total effective rates for groups A1 and B1 (x2 =6.218,P ＜ 0.05).PTA values of groups A1 and B1 were higher than that of group C (P ＜ 0.05),and the feeling of ear stuffiness in patients of group D was obviously lighter following treatment.Conclusions HBO therapy combined with dexamethasone sodium phosphate and ginkgo leave extract injection was an effective method for the treatment of SHL.HBO therapy at 0.16 MPa could achieve quite satisfactory results,and was economical as well.For patients with an obvious feeling of ear stuffiness could receive oxygen breathing at a pressure of 0.07 MPa.