中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
CHINESE JOURNAL OF NAUTICAL MEDICINE AND HYPERBARIC MEDICINE
2014年
2期
120-123
,共4页
赵津京%吕艳%麦乃铿%杨晨%王凯%潘树义
趙津京%呂豔%麥迺鏗%楊晨%王凱%潘樹義
조진경%려염%맥내갱%양신%왕개%반수의
突发性聋%高压氧%药物治疗%纯音测听
突髮性聾%高壓氧%藥物治療%純音測聽
돌발성롱%고압양%약물치료%순음측은
Sudden hearing loss%Hyperbaric oxygen%Drug treatment%Pure tone audiometry
目的 对比观察不同吸氧方法联合药物治疗突发性聋(sudden hearing loss,SHL)的疗效,探讨SHL治疗新模式.方法 依据选定的标准,挑选海军总医院2011年2月至2013年8月收治的SHL患者101例,均给予地塞米松磷酸钠注射液、银杏叶提取物注射液等药物治疗.按给氧方式不同分为A、B、C组,A组37例联合0.20 MPa高压氧治疗;B组37例联合0.16 MPa高压氧治疗;C组27例联合0.10 MPa(常压)面罩吸纯氧治疗.A组3例、B组6例治疗期间出现耳闷加重、查鼓室声阻抗为C型曲线,将其调整为低压舱吸氧治疗,压力0.07 MPa(设为D组,共9例).A组剩余34例患者为A1组,B组剩余31例患者为B1组.所有患者均于治疗前、治疗第14天查纯音测听和鼓室声阻抗.结果 A1、B1、C、D组总有效率分别为82.4%、83.9%、59.3%、77.8%.治疗前后平均听阈值分别提高了(43.7±17.4)dB、(46.3±21.2)dB、(28.1±12.3)dB、(41.9±19.8)dB.A1、B1组总有效率与C组比较,差异有统计学意义(P <0.05);A1、B1组治疗前后平均听阈提高值高于C组(P<0.05),D组患者耳闷堵感症状明显减轻.结论 高压氧联合地塞米松磷酸钠注射液、银杏叶提取物注射液是治疗SHL的有效方法.0.16 MPa高压氧疗效满意,经济成本低,更具优势;耳闷堵感症状明显时可调整为0.07 MPa低压舱吸氧治疗.
目的 對比觀察不同吸氧方法聯閤藥物治療突髮性聾(sudden hearing loss,SHL)的療效,探討SHL治療新模式.方法 依據選定的標準,挑選海軍總醫院2011年2月至2013年8月收治的SHL患者101例,均給予地塞米鬆燐痠鈉註射液、銀杏葉提取物註射液等藥物治療.按給氧方式不同分為A、B、C組,A組37例聯閤0.20 MPa高壓氧治療;B組37例聯閤0.16 MPa高壓氧治療;C組27例聯閤0.10 MPa(常壓)麵罩吸純氧治療.A組3例、B組6例治療期間齣現耳悶加重、查鼓室聲阻抗為C型麯線,將其調整為低壓艙吸氧治療,壓力0.07 MPa(設為D組,共9例).A組剩餘34例患者為A1組,B組剩餘31例患者為B1組.所有患者均于治療前、治療第14天查純音測聽和鼓室聲阻抗.結果 A1、B1、C、D組總有效率分彆為82.4%、83.9%、59.3%、77.8%.治療前後平均聽閾值分彆提高瞭(43.7±17.4)dB、(46.3±21.2)dB、(28.1±12.3)dB、(41.9±19.8)dB.A1、B1組總有效率與C組比較,差異有統計學意義(P <0.05);A1、B1組治療前後平均聽閾提高值高于C組(P<0.05),D組患者耳悶堵感癥狀明顯減輕.結論 高壓氧聯閤地塞米鬆燐痠鈉註射液、銀杏葉提取物註射液是治療SHL的有效方法.0.16 MPa高壓氧療效滿意,經濟成本低,更具優勢;耳悶堵感癥狀明顯時可調整為0.07 MPa低壓艙吸氧治療.
목적 대비관찰불동흡양방법연합약물치료돌발성롱(sudden hearing loss,SHL)적료효,탐토SHL치료신모식.방법 의거선정적표준,도선해군총의원2011년2월지2013년8월수치적SHL환자101례,균급여지새미송린산납주사액、은행협제취물주사액등약물치료.안급양방식불동분위A、B、C조,A조37례연합0.20 MPa고압양치료;B조37례연합0.16 MPa고압양치료;C조27례연합0.10 MPa(상압)면조흡순양치료.A조3례、B조6례치료기간출현이민가중、사고실성조항위C형곡선,장기조정위저압창흡양치료,압력0.07 MPa(설위D조,공9례).A조잉여34례환자위A1조,B조잉여31례환자위B1조.소유환자균우치료전、치료제14천사순음측은화고실성조항.결과 A1、B1、C、D조총유효솔분별위82.4%、83.9%、59.3%、77.8%.치료전후평균은역치분별제고료(43.7±17.4)dB、(46.3±21.2)dB、(28.1±12.3)dB、(41.9±19.8)dB.A1、B1조총유효솔여C조비교,차이유통계학의의(P <0.05);A1、B1조치료전후평균은역제고치고우C조(P<0.05),D조환자이민도감증상명현감경.결론 고압양연합지새미송린산납주사액、은행협제취물주사액시치료SHL적유효방법.0.16 MPa고압양료효만의,경제성본저,경구우세;이민도감증상명현시가조정위0.07 MPa저압창흡양치료.
Objective To compare and observe the clinical effects of different oxygen-breathing methods coupled with drugs in the treatment of sudden hearing loss (SHL),so as to explore new approaches for the treatment of the illness.Methods In accordance with the set criteria,101 cases of sudden hearing loss admitted into the center from Feb.2011 to Aug.2013 were selected for our study.All the patients received injections of dexamethasone sodium phosphate,ginkgo leave extract injection and other drug treatment.Then,the patients were randomly allocated to groups A,B and C in accordance with different methods of oxygenbreathing.Group A (37 cases) received drug treatment coupled with 0.20 MPa hyperbaric oxygen (HBO) therapy; Group B (also 37 cases) received the same drug treatment coupled with 0.16 MPa HBO therapy; and Group C (27 cases) received the same drug treatment coupled with 0.10 MPa (normal pressure) oxygen maskbreathing.During HBO therapy,the feeling of ear stuffiness in 3 patients from group A and 6 patients from group B was worsened and "C curve" of tympanic acoustic impedance was shown,and these 9 cases changed to receive low pressure oxygen breathing at 0.07 MPa,and were assigned as group D.The remaining 34 patients in group A and 31 patients in group B were then respectively assigned as group A1 and group B1.Pure tone audiometry and tympanic acoustic impedance detection were performed in all the patients both before treatment and at d 14 after treatment.Results Total effective rates for groups A1,B1,C and D were 82.4%,83.9%,59.3% and 77.8% respectively.Pure tone average (PTA) were respectively increased by (43.7 ± 17.4) dB,(46.3±21.2)dB,(28.1 ± 12.3)dB and (41.9 ± 19.8)dB.When compared with the control group,statistical difference could be seen in total effective rates for groups A1 and B1 (x2 =6.218,P < 0.05).PTA values of groups A1 and B1 were higher than that of group C (P < 0.05),and the feeling of ear stuffiness in patients of group D was obviously lighter following treatment.Conclusions HBO therapy combined with dexamethasone sodium phosphate and ginkgo leave extract injection was an effective method for the treatment of SHL.HBO therapy at 0.16 MPa could achieve quite satisfactory results,and was economical as well.For patients with an obvious feeling of ear stuffiness could receive oxygen breathing at a pressure of 0.07 MPa.