CAJ | 학술논문

目的研究影响突发性聋预后的相关因素,提高突发性聋预后的判断.方法回顾性分析2006年1月至2007年3月复旦大学附属眼耳鼻喉科医院收治的突发性聋患者,首先去除初始听阈≤40 dB的低频聋患者,得到882例进行疗效分析.初始听阈＞40 dB的患者按不同的初始听阈形态与严重程度分为下坡型组(69例)、上坡型组(24例)、平坦型组(139例)、凹陷型组(44例)、极重度聋(126例)和全聋(86例)6组.结果病程3 d内疗效最佳,其次是1、2周内,超过2周疗效差,3周内和1个月内、1个月后差异无统计学意义.病程2周内患者初始听阈＞40 dB组中凹陷型组与其他组相比预后最佳,恢复率达97.7%.极重度聋组和其他组(除全聋组)相比,治愈率(23.8%)及恢复率(57.9%)低,但好于全聋组.全聋组的预后最差,无效率达67.4%.合并有糖尿病、高血压患者的预后与其他不伴此病的患者相比差异具有统计学意义(H=4.455,P=0.0348).年龄与预后有关,年龄越大,预后也越差,以50岁为界,＜50岁的患者的预后要好于≥50岁的患者,差异有统计学意义(H=7.739,P=0.0054).结论病程大于2周的患者疗效差,不同的初始听阈形态与听力损失程度是影响突发性聋预后的重要因素.年龄越大预后越差.合并有高血压、糖尿病的患者,其预后比无任何合并症的患者差.
목적 연구영향돌발성롱예후적상관인소,제고돌발성롱예후적판단.방법 회고성분석2006년1월지2007년3월복단대학부속안이비후과의원수치적돌발성롱환자,수선거제초시은역≤40 dB적저빈롱환자,득도882례진행료효분석.초시은역＞40 dB적환자안불동적초시은역형태여엄중정도분위하파형조(69례)、상파형조(24례)、평탄형조(139례)、요함형조(44례)、겁중도롱(126례)화전롱(86례)6조.결과 병정3 d내료효최가,기차시1、2주내,초과2주료효차,3주내화1개월내、1개월후차이무통계학의의.병정2주내환자초시은역＞40 dB조중요함형조여기타조상비예후최가,회복솔체97.7%.겁중도롱조화기타조(제전롱조)상비,치유솔(23.8%)급회복솔(57.9%)저,단호우전롱조.전롱조적예후최차,무효솔체67.4%.합병유당뇨병、고혈압환자적예후여기타불반차병적환자상비차이구유통계학의의(H=4.455,P=0.0348).년령여예후유관,년령월대,예후야월차,이50세위계,＜50세적환자적예후요호우≥50세적환자,차이유통계학의의(H=7.739,P=0.0054).결론 병정대우2주적환자료효차,불동적초시은역형태여은력손실정도시영향돌발성롱예후적중요인소.년령월대예후월차.합병유고혈압、당뇨병적환자,기예후비무임하합병증적환자차.
Objective To assess the prognostic factors associated with the sudden idiopathic sensorineural hearing loss,to predict the prognosis of patient with idiopthic sensorneural hearing loss precisely.Methods Eight hundreds and eishty two patients with idiopathic sudden sensorineural hearing loss were retrospectively reviewed during January 2006 to March 2007.Patients whose initial hearing threshold ≤40 dB were excluded.The patients with initial hearing threshold ＞40 dB were recruited,which was divided into six subgroups based on the patterns of audiogram:downgrade audiogram subgroup,upgrade audiogram subgroup,flat audiogram subgroup,concave audiogram subgroup,profound audiogram subgroup and total deafness subgroup.Results Regarding to the relationship between the time point for initiaI intervention and the prognosis,better prognosis was obtained in patients whose initial intervention war within 3 days of the disease,good prognosis was achieved within 1 or 2 weeks of the disease,poor prognosis was noted beyond 2 weeks of this disease.Furthermore,comparison with the initial intervention within 3 week,1 month and 1 month later,the prognosis among them was not statistical different.97.7% hearing recovery was achieved in the concave subgroup with the initial hearing threshold ＞40 dB group.Comparison with the other subgroup (except total deafness subgroup),the cure rate and recovery rate was 23.8% and 57.9% respectively in the profound subgroup.Poor prognosis was demonstrated in the total deafness subgroup and inefficacy rate was 67.4% in the total deafness subgroup.Comparison with patients without companying complications,the prognosis of patients with companying complications such as diabetes or high blood pressure has negative impact in hearing recovery.The age wag correlated with the prognosis,elder had poor prognosis,patients more than 50 years old present with worse hearing than that less than 50 years old(H=7.851,P=0.0051).Conclusions The initial intervention beyond 2 weeks had negative impact on the prognosis.The initial audiogram patterns and hearing threshold were both significant factors on the prognosis of idiopathic sudden sensorineural hearing loss.In addition,old patient had poor prognosis.The companying complications such as high blood pressure and diabetes had negative impact on the prognosis of idiopathic sudden hearing sensorineural loss.