CAJ | 학술논문

目的 :探讨不同药物及 /或方法组合对突发性耳聋(sudden deafness, 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%,χ 2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 7 d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 15 d总有效率为 50.8%,至 30 d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～ 30 d为宜.
목적 :탐토불동약물급 /혹방법조합대돌발성이롱(sudden deafness, SD)환자적료효급기영향인소. 방법 :84례(89이) SD환자분위 3조. I조 24례(28이)용뇌혈관확장제、강저혈액점체도급내이신경결구보호약물, II조 33례(34이),재상술약물기출상가겁화액. I, II조용정맥통도급약,병용고압양(HBO). III조 27례(27이),전부용니막지평혹불계리진구복,단삼제제기육주사혹구복,병용신경결구보호제,불용 HBO. 결과 :3조유효솔의차위 67.86%, 64.71%, 70.37%,χ 2검험차이불현저;불동은력곡선대료효유영향,저빈형유효솔위 84.6%,고빈형유효솔위 44.4%;우발병 7 d내치료적병례최유효,전유급현효솔위 77.8%급 94.7%, 1개월이후소수병례유효;치료 15 d총유효솔위 50.8%,지 30 d이체 84.7%. 결론 :3조환자용불동약물급 /혹불동방법조합,료효차이불명현,응이용개선내이미순배、강저혈액점체도、보호내이신경결구적약물위주; HBO、겁화액병불일정능제고료효;대 SD의조기치료,발병 7천내료효최호,료정이 15～ 30 d위의.
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.