高压氧综合治疗突发性耳聋最佳方案和预后探讨

摘要

目的：研究应用高压氧治疗突发性耳聋的最优方案与预后。方法57例（70耳）突发性耳聋患者均进行高压氧治疗，根据患者病时的不同情况（年龄、患病天数，就诊时听力损失，高压氧治疗疗程）等进行分组分析。结果由单因素相关分析结果可知，治疗效果随患者年龄增大而明显降低，其中以9~19岁患者就诊时总体治疗效果最佳；此外，就诊时间及就诊时听力损失程度也在一定程度上影响患者后期治疗效果，且由Spearman相关系数显示，两者均与治疗效果呈负相关；随着高压氧治疗时间增加，患者治疗有效率也明显增加，但超过24个疗程时，其有效率迅速降低；同时，若合并有眩晕症状患者其治疗效果明显低于无次症状患者（ P <0.01）。而经多因素Logistic分析可知，如年龄、就诊时间、就诊时听力损伤程度、高压氧疗程及是否伴有眩晕均可影响患者预后情况。结论突发性耳聋患者采取早诊断、早治疗及合理使用高压氧的疗法及次数可有效提高患者预后治疗效果，但在治疗过程中，仍需考虑患者治疗前的听力损失程度及是否伴有眩晕等症状。%Objective To find the best regimen of hyperbaric oxygen( HBO)in treatment of patients with sudden deafness( SD). Meth-ods A total of 57 patients(70 ears)with sudden deafness were treated with HBO and they were divided into different groups for analysis of their conditions such as the duration of illness,the severity of hearing loss at consulting physicians,the course of HBO and so on. Results The results of single factor correlation analysis showed that effect of treatment was significantly decreased following the increase of age of patients,it was the best in patients with 9~19 years old. Furthermore,the degree of hearing loss,the time for diagnosis and duration of treatment were also in some extent affected the effect of treatment,and the result of Spearman correlation coefficients showed that both were negatively correlated with the thera-peutic effect,and this study also found that following the increase of times for hyperbaric oxygen therapy,the efficiency of treatment was also signif-icantly increased,but if the treatment was taken more than 24 courses,its efficiency would be rapidly decreased. If it associated with symptoms of vertigo,then its therapeutic effect would be significantly lowered than those patients without secondary symptoms( P <0. 01). The Multivariate Logistic analysis showed that age,time for consultation to physicians,the degree of hearing loss,the course of hyperbaric oxygen treatment and the association with vertigo can affect the prognosis of patients. Conclusion Patients with sudden deafness should be early diagnosed and treated,and the frequency of rational application of hyperbaric oxygen therapy can effectively improve the prognosis of patients,but during the course of treat-ment,it still need to consider the degree of hearing loss of patients before treatment and whether it associate with dizziness and other symptoms.