CAJ | 학술논문

目的观察伴有全频听力损失的突发性耳聋患者高压氧治疗后听力的动态变化特点.方法经耳鼻喉科确诊的82例全频听力损失的突发性耳聋患者,经患者知情同意,并签署知情同意书后分为对照组40例、高压氧组(HBO组)42例.对照组给予常规治疗:10 mg地塞米松静脉输液3d后,减为5 mg地塞米松静脉输液3d;前列地尔10 μg静脉滴注,1次/d,连续14 d；维生素B1100 mg、B12500 μg肌肉注射,1次/d,连续30 d.HBO组在常规治疗基础上给予HBO治疗,1次/d,10次为1个疗程,连续治疗2个或4个疗程后复查纯音测听.结果治疗2个疗程后,与对照组的低频听力提高值[(24.68 ±3.87) dB]相比,HBO组的低频听力提高值[(38.16 ±5.88) dB]增加,差异有统计意义(P＜0.01)；与对照组的高频听力提高值[(10.49±2.34)dB]相比,HBO组的高频听力提高值[(12.33±2.98)dB]有一定增加,但差异无统计学意义(P＞0.05)；多数患者以低频听力改善为主,恢复较快；与对照组的总有效率(62.5％)比较,HBO组总有效率(80.9％)提高,但差异无统计学意义(P＞0.05).与低频听力改善相比,高频听力恢复比较缓慢,在第4个疗程结束时,患者纯音测听主要以高频听力改善为主；与对照组的低频听力提高值[(37.80±5.91) dB]相比,HBO组低频听力提高值[(46.51±6.11)dB]增加,差异有统计意义(P＜0.05)；与对照组的高频听力提高值[(9.71±1.52)dB]相比,HBO组的高频听力值[(19.82 ±4.13) dB]增加,差异有统计意义(P＜0.01)；与对照组的总有效率(67.5％)比较,HBO组的总有效率(85.7％)提高,但差异无统计学意义(P＞0.05).结论 HBO治疗可改善全频听力损失突发性耳聋患者的低频或/和高频听力水平,提高治疗的总有效率.
목적 관찰반유전빈은력손실적돌발성이롱환자고압양치료후은력적동태변화특점.방법 경이비후과학진적82례전빈은력손실적돌발성이롱환자,경환자지정동의,병첨서지정동의서후분위대조조40례、고압양조(HBO조)42례.대조조급여상규치료:10 mg지새미송정맥수액3d후,감위5 mg지새미송정맥수액3d;전렬지이10 μg정맥적주,1차/d,련속14 d；유생소B1100 mg、B12500 μg기육주사,1차/d,련속30 d.HBO조재상규치료기출상급여HBO치료,1차/d,10차위1개료정,련속치료2개혹4개료정후복사순음측은.결과 치료2개료정후,여대조조적저빈은력제고치[(24.68 ±3.87) dB]상비,HBO조적저빈은력제고치[(38.16 ±5.88) dB]증가,차이유통계의의(P＜0.01)；여대조조적고빈은력제고치[(10.49±2.34)dB]상비,HBO조적고빈은력제고치[(12.33±2.98)dB]유일정증가,단차이무통계학의의(P＞0.05)；다수환자이저빈은력개선위주,회복교쾌；여대조조적총유효솔(62.5％)비교,HBO조총유효솔(80.9％)제고,단차이무통계학의의(P＞0.05).여저빈은력개선상비,고빈은력회복비교완만,재제4개료정결속시,환자순음측은주요이고빈은력개선위주；여대조조적저빈은력제고치[(37.80±5.91) dB]상비,HBO조저빈은력제고치[(46.51±6.11)dB]증가,차이유통계의의(P＜0.05)；여대조조적고빈은력제고치[(9.71±1.52)dB]상비,HBO조적고빈은력치[(19.82 ±4.13) dB]증가,차이유통계의의(P＜0.01)；여대조조적총유효솔(67.5％)비교,HBO조적총유효솔(85.7％)제고,단차이무통계학의의(P＞0.05).결론 HBO치료가개선전빈은력손실돌발성이롱환자적저빈혹/화고빈은력수평,제고치료적총유효솔.
Objective To observe the dynamic characteristics of hearing recovery in full-frequency hearing loss in the patients with sudden deafness following HBO therapy.Methods Eighty-two cases of fullfrequency hearing loss confirmed by ENT specialists were randomly divided into the control group (40 cases)and the HBO therapy group (42 cases).The patients in the control group were given routine treatment,i.e.10mg of dexamethasone intravenous infusion for first 3 days,then,5 mg of dexamethasone for another 3 days.Besides,the patients were administered 10 μg alprostadil intravenous infusion,once a day for 14 consecutive days; 100 mg of Vitamin B1,500 μg of B12 muscular injection,once day for 30 consecutive days.The patients in the HBO therapy group were given HBO therapy + routine treatment,once a day,10 sessions a treatment course.Following 2 or 4 consecutive treatment courses,pure tone audiometry was performed.Results After 2 courses of HBO therapy,low-frequency average hearing level [(38.16 ± 5.88) dB] increased for the patients in the HBO therapy group,when compared with that of the patients in the control group[(24.68 ± 3.87) dB],with statistical significance (P ＜ 0.01).On the other hand,high-frequency average hearing level [(12.33 ± 2.98) dB] increased to some extent for the patients in the HBO therapy group,when compared with that of the patients in the control group [(10.49 ± 2.34) dB],without statistical significance(P ＞ 0.05).For most patients,low-frequency hearing level improved more markedly and recovered more quickly.Total effective rate (80.9％) for the HBO group increased,when compared with that of the control group (62.5％),but without statistical significance (P ＞ 0.05).When compared with low-frequency hearing level,high-frequency hearing level recovered more slowly.At the end of the 4 courses,pure tone monitoring indicated that improvement was seen mainly in high-frequency hearing level.For the patients in the HBO therapy group,highfrequency average hearing level [(46.51 ±6.11)dB] elevated,when compared with that of the patients in the control group[(37.80 ± 5.91)dB],with statistical significance(P ＜ 0.05).For the patients in the HBO group,high-frequency average hearing level [(19.82 ± 4.13) dB] increased,when compared with that of the patients in the control group[(9.71 ± 1.52)dB],with statistical significance(P ＜ 0.01).Total effective rate (85.7％)for the HBO group increased,when compared with that of the control group(67.5％),but without statistical significance(P ＞ 0.05).Conclusions HBO therapy could improve low-frequency and/or highfrequency hearing levels in full-frequency hearing loss in the patients with sudden deafness and could also increase total effective rate.