影响内淋巴囊减压术后生活质量的相关因素分析

Factors Affecting Quality of Life after Endolymphatic Sac Surgery

目的研究内淋巴囊减压术治疗梅尼埃病的临床效果;通过患者术后生活质量评分分析手术适应症及影响手术效果的相关因素。方法病例材料来源于北京大学人民医院耳鼻咽喉科1996年至2011年收治的梅尼埃病病例共71例,选择反复发作眩晕且有实用听力者进行内淋巴囊减压术,术前完善检查并根据听力分期、听力曲线、病程、随访期限等进行分组,术后进行随访,生活质量的评测采用梅尼埃病内淋巴囊减压术生活质量调查问卷MDOQ。结果内淋巴囊减压术后生活质量相应改善的梅尼埃患者为87.69%,3.08%不变,9.23%变差。QOL的得分与年龄、性别、随访时间、病程等无明显统计学相关,与术前听力分期、术前听力学曲线类型有统计学意义。结论内淋巴囊减压术能有效改善梅尼埃病患者的术后生活质量。术前不同分期与内淋巴囊减压术后疗效有明显统计学差异,分期为2、3期的患者疗效要好于4期患者,听力曲线为上升型的效果优于其他类型。

Objective To investigate the efficacy of endolymphatic sac decompression （ELSD） for the treatment of Mtnibre＇ s disease and to study indications for the procedure and factors affecting the outcome. Methods Seventy one pa- tients who underwent ELSD from 1996 to 2011 were followed up. Recurrent vertigo and useful hearing were confirmed be- fore the surgery. Follow up included telephone and mail surveys. Results Quality of life was reportedly improved in 87.69%, remained unchanged in 3.08% and deteriorated in 9.23% of the patients. Quality of life （QOL） scores were not cor- related to age, gender, follow-up duration, or duration of disease, but to preoperative hearing status and audiogram patterns. Conclusion QLSD can effectively control vertigo and improve quality of life. The procedure seems to be more effective in patients with Stage 2 or 3 hearing than in those with stage 4 hearing. It is also more effective in patients with rising curve au- diogram than others.