药物联合高压氧治疗突发性聋132例

Effect of hyperbaric oxygen treatment combined with drug therapy on sudden deafness

目的探讨药物联合高压氧治疗(hyperbaric oxygentreatment,HBOT)突发性聋的效果。方法连续就诊的261例突发性聋患者随机分为药物治疗组(对照组)和HBOT结合药物治疗组(CHBOT),对照组采用常规药物治疗,HBOT组除上述药物治疗外,在舱内压力达0.20MPa下,吸纯氧30min2次(中间吸空气10min),1/d。在治疗后第30天或其间结束治疗的时间点按预定疗效指标评价。结果与对照组相比,CHBOT组听力显著改善(P<0.01);耳鸣显著减轻,有效率为76.8%,对照组为56.63%(P<0.01)。在有眩晕的患者中,CHBOT组98.11%的患者消失,而对照组仅83.3%消失(P<0.05)。CHBOT组疗程明显短于对照组(P<0.01)。分析显示,无论采用何种治疗方法,入院前病程长、听力丧失(PTA>55dB)明显以及伴随眩晕的患者预后差。结论CHBOT治疗突发性聋的疗效明显优于单纯药物治疗。尽早启动HBOT结合药物治疗是提高突发性聋治愈率的重要途径。

Objective To investigate the effect of hyperbaric oxygen treatment （HBOT） combined with drug therapy on sudden deafness （SD）.Methods 261 patients （325 ears） with SD were randomized into drug therapy（control） group（including intravenous energy mixture,injection Salvia miltiorrhiza Co, dextran 40, vitamin B complex, and corticoids,onee a day） and HBOT combined with above- mentioned drug therapy group（CHBOT） .HBOT consisted of twice pure oxygen breathing under inboard pressure 0.20 MPa for 30 min, with a 10 min interval for air breathing in the chamber, once a day. At hospital day 30, clinical outcomes were assessed according to preestablished criteria. Resuits The auditory acuity of patients in CHBOT group was improved more markedly than that in control group （ P 〈 0.01 ）. Tirmitus in CHBOT group significantly improved with an effective rate of 76.8% ,compared with that of 56.63% in control group（ P 〈 0.01 ） .Staggering disappeared in 98.11% cases of CHBOT group in contrast to 83.3 % in control group （ P 〈 0.05）. The duration of CHBOT was shorter （17.60± 8.75 d） than that of control group （22.36± 10.61d）（ P 〈 0.01）.Patients who had long course of disease before hospitalization, high hearing loss（PTA 〉 55 dB）, and accompanied staggering had poorer outcomes, irrespective of treatment methods. Conclusion The therapeutic effect of CHBOT combined with drug therapy for SD is significantly better than that of simple drug treatment without HBOT.As early as possible initiation of CHBOT is an important approach to enhancing healing rate in sudden deafness.