新型低压氧舱治疗低频波动性感音神经性听力损失的临床前瞻性研究

The Clinical Prospective Studies on Treatment of New Hypobaric Oxygen Chamber Methods for Low-frequency Fluctuating Sensorineural Hearing Loss

目的探讨新型低压氧舱方法治疗低频波动性感音神经性听力损失的临床效果。方法采用低压氧舱模拟低气压环境对20例低频波动性感音神经性听力损失患者进行治疗。治疗方案为三个循环，以3m／s的速度从正常大气压降至2200m海拔气压水平（约78．6kPa），保持5min后，以1m／s的速度增压至1100m气压水平；随后以同样的速度完成第二、三个循环，最后以1m／s的速度恢复至正常大气乐。患者在550m海拔以上气压水平以150L／h的流速采Ⅲ鼻吸管持续吸氧。每日治疗1次，5次为1疗程。轻度听力损失治疗1个疗程，中度听力损失一般治疗2个疗程，每疗程间休息2d。对比分析治疗前后患者纯音测听结果及耳闷堵、耳鸣、颅呜主观症状程度变化。结果20例患者全身状态良好，无不良反应。听力损失治愈7例，改善4例，无效9例，总有效率为55％（11／20）。轻度和中度听力损失两组患者听力疗效之间的差别有统计学意义（P〈0．05）。耳闷堵感治愈17例，有效2例，无效1例，总有效率为95％（19／20）；耳呜有效12例，无效8例，总有效率为60％（12／20）；颅鸣共2例，无效。随访4-6个月，治疗有效的患者仅1例因上呼吸道感染后耳闷堵感复发，重复低压氧舱治疗效果为有效。结论新型低压氧舱为一种无创伤性治疗方法，对低频波动性感音神经性听力损失有较好的治疗效果，尤其是可显著改善患者的耳闷堵感，具有重要的临床应用价值。

Objective To investigate the clinical effects of new hypobaric oxygen chamber methods for low-frequency fluctuating sensorineural hearing loss. Methods Twenty cases with low-frequency fluctuating sensorineural hearing loss were included in the study, whose pure tone threshold and subjective symptoms degrees （ear stuffiness blocking, tinnitus, cranial tinnitus） were evaluated before and after exposed to hypobaric pressure in chamber. Treatment program had three cycles. In the first cycle, chamber pressure changed at the speed of 3 m/s from normal atmospheric pressure up to 2200 m altitude, about 78.6 kPa, maintain for 5 min, then down to 1100 m at 1 m/s speed. The cycle repeated twice. Finally, pressure returned to normal atmospheric pressure at the speed of lm/s. All patients breathing pure oxygen continually with 150 L/h flow rate when the atmospheric pressures lower than 550 m altitude. Once every day, 5 times as a course of treatment. Patients with mild hearing loss were treated one course, and those with moderate hearing loss were treated two courses. There were 2 days rest between the two courses. Results All cases had no adverse reactions. Pure tone threshold showed that 55% （11/20） improved in hearing, in which 7 cases were cured and 4 cases were improved. The difference of hearing efficacy between mild and moderate hearing loss groups was statistically significant （P 〈 0.05）. The total effective rate of ear stuffiness was 95% （19/20）, in which 17 cases were cured and 2 cases improved. Total improved rate of tinnitus was 60%（12/20）; Patients were followed up for four to six months. Only one case recurred with ear stuffiness. Then he accepted repeat hypobaric oxygen chamber treatment and cured again. Conclusions As a good non-invasive method, new hypobaric oxygen chamber can be an additional choice to treat low-frequency fluctuating sensorineural hearing loss, in particular improve ear stuffiness significantly.