高压氧对不同听力损失程度与听力曲线突发性聋患者的疗效观察

The effect of hyperbaric oxygen therapy to different degree of hearing loss and types of threshold curve in sudden deafness patients

目的:探讨不同听力损失程度与不同听力曲线的突发性聋(突聋)患者对高压氧治疗疗效的影响,为制订个性化的治疗方案提供理论依据。方法:120例突聋患者被分成2组,每组60例。A组单纯药物治疗,B组在A组的基础上同时加用高压氧治疗;疗程2周。分析不同听力损失程度与不同听力曲线的突聋患者两种治疗方案疗效的差异。结果:A、B两组总有效率分别为60.00%(36/60)和83.33%(50/60),差异有统计学意义(χ2=8.044,P<0.01)。轻度和极重度聋时,两种治疗方案疗效差异无统计学意义;中度和重度聋时,两组疗效差异有统计学意义,其χ2分别为4.969和5.560,均P<0.05。在A组中,轻度与极重度疗效差异有统计学意义(χ2=6.739,P<0.05),其他不同程度耳聋之间的疗效均未显示出统计差异(χ2<3.910,P>0.05)。B组中,轻度与极重度、中度与极重度、重度与极重度疗效差异均有统计学意义,其χ2分别为11.500、15.058、10.221,均P<0.01,其他不同程度耳聋之间的疗效未显示出统计差异(χ2<1.313,P>0.05)。在上升型和全聋型听力曲线中,A、B两种治疗方案疗效差异均无统计学意义。而下降型和平坦型听力曲线中,A、B两种治疗方案疗效差异有统计学意义,其χ2分别为5.144和5.969,均P<0.05。在A组中,上升-下降、上升-平坦、上升-全聋型听力曲线间疗效差异均有统计学意义,其χ2分别为6.188、7.247、8.082,均P<0.05。而其他各型听力曲线间差异无统计学意义(χ2<0.566,P>0.05)。在B组中,各型听力曲线间疗效差异均无统计学意义(χ2<4.200,P>0.05)。结论:高压氧治疗疗效在不同的听力损失程度与不同听力曲线的突聋患者中有一定的差异,对中、重度听力损失及下降型与平坦型听力曲线者,药物联合高压氧治疗显示出一定的优势。

Objective：To investigate the effect of hyperbaric oxygen therapy to different degrees of hearing loss and different types of threshold curve in sudden deafness patients,and establish a personalized therapy,so as to promote clinical effect to sudden deafness.Method：One hundred and twenty cases were divided into two groups respectively（each group 60cases）.Drug treatment had been used in group A for two weeks.The patients in group B received drug treatment combined with hyperbaric oxygen therapy for two weeks.According to the different degrees of hearing loss and the types of audiogram in two groups,the statistical analysis to the difference of hyperbaric oxygen therapeutic effect was done.Result：The effective rates was statistically different（χ2=8.044,P 0.01）between group A（60.00%,36/60）and group B（83.33%,50/60）.There was no statistical difference between two treatment program in mild and the profound deafness patiens.The statistical difference could been found between moderate and the severe deafness,the value ofχ2 and p were 4.969,5.560and 0.040,0.035,respectively.In group A,the statistical difference could only been found between mild and the profound deafness patiens（χ2=6.739,P0.05）.In group B,the statistical difference could been found in mild and the profound deafness,the moderate and the profound deafness,the severe and the profound deafness patiens.The value ofχ2 were 11.500,15.058,10.221and P0.01respectively.The effective rates was no statistical difference in two treatment programs in the upsloping audiogram and the profound deafness.The statistical difference could been found between the downsloping and the flat audiogram,with the value ofχ2 and p were 5.144and 5.969,P0.05,respectively.In group A,the statistical difference could been found betweeen the ascending and descending audiogram,the ascending and the flat audiogram,the ascending type and the profound deafness.The value ofχ2 were 6.188,7.247,8.082and P0.05,respectively.No statistical difference could been found among the other types of audiogram.In group B,no statistical difference could been found among all types of audiogram.Conclusion：The effect of hyperbaric oxygen therapy varies with degree of hearing loss andaudiogram type.Drug treatment combined with HBOT can promote clinical effect for patiens in moderate deafness and severe deafness,the descending and flat type of audiogram.