CAJ | 학술논문

目的：探讨溶栓治疗中、重度平坦型突发性聋的疗效。方法回顾性分析了150例突发性聋患者的临床资料，将患者随机分为治疗组、对照组和单纯纤溶酶治疗组，每组分别为60、60、30例。前两组均给予扩血管、营养神经、糖皮质激素、高压氧等常规治疗，治疗组在此基础上加用纤溶酶溶栓治疗，第3组仅单独使用纤溶酶治疗。治疗时间10天，比较三组疗效。结果治疗组、对照组及单纯纤溶酶治疗组的总有效率分别为80.0％、71.7％和63.3%，两两组比较差异无统计学意义(P>0.05)，治疗组、对照组及单纯纤溶酶组痊愈+显效率分别为60.0％、41.7％和26.7%，治疗组及对照组、治疗组及单纯纤溶酶组比较差异有统计学意义(P<0.05)，对照组及单纯纤溶酶组比较差异无统计学意义（P>0.05）。结论在扩血管、营养神经、糖皮质激素、高压氧等常规治疗的基础上加用溶栓治疗并不能得到较常规治疗及单纯溶栓治疗更高的有效率，但能更大程度提高患者听力，增加患者满意度，减少致残率，无不良反应发生，对中、重度平坦型突发性聋应联合用药。
목적：탐토용전치료중、중도평탄형돌발성롱적료효。방법회고성분석료150례돌발성롱환자적림상자료，장환자수궤분위치료조、대조조화단순섬용매치료조，매조분별위60、60、30례。전량조균급여확혈관、영양신경、당피질격소、고압양등상규치료，치료조재차기출상가용섬용매용전치료，제3조부단독사용섬용매치료。치료시간10천，비교삼조료효。결과치료조、대조조급단순섬용매치료조적총유효솔분별위80.0％、71.7％화63.3%，량량조비교차이무통계학의의(P>0.05)，치료조、대조조급단순섬용매조전유+현효솔분별위60.0％、41.7％화26.7%，치료조급대조조、치료조급단순섬용매조비교차이유통계학의의(P<0.05)，대조조급단순섬용매조비교차이무통계학의의（P>0.05）。결론재확혈관、영양신경、당피질격소、고압양등상규치료적기출상가용용전치료병불능득도교상규치료급단순용전치료경고적유효솔，단능경대정도제고환자은력，증가환자만의도，감소치잔솔，무불량반응발생，대중、중도평탄형돌발성롱응연합용약。
Objective To explore the therapeutic effect of thrombolytic therapy on sudden deafness patients with moderate to severe degrees of flat type audiogram.Methods A total of 150 sudden deafness patients with moderate to severe degrees of flat type of audiogram was randomly divided into 3 groups, 60, 60 and 30 cases in each respectively. The first two groups were given the vasodilators, neurotrophic agents, glucocorticoids, and hyperbaric oxygen therapy, with the treatment group aided with plasminogen activator treatment. The third group was used fibrinolytic treatment alone. Therapeutic course was 10 days, with therapeutic outcome compared among the three groups.Results The total effective rate of the treatment group, the control group and the simple group were 80%, 71.7% and 63.3% respectively, and there were no significant differences among them (P>0.05). The total cure and markedly effective rates of them were 60%, 41.7% and 26.7%, respectively, with significant differences between the treatment group and the control group (P<0.05), and no significant differences between the control group and the simple group (P>0.05).Conclusions The thrombolytic therapy based on the use of vasodilators, neurotrophic agents, glucocorticoids, hyperbaric oxygen therapy can not get higher efficiency, when compared with those of conventional treatment and those of simple fibrinolytic treatment, on sudden deafness patients with moderate to severe degrees of flat type of audiogram. The thrombolytic therapy can improve the hearing of patients,increase patients satisfaction and reduce the rate of disability. What’s more, there is no adverse reaction. In a word, we should take the combination therapy on such cases.