病程超过1周重度以上突发性聋的短期疗效分析

Short-term effect of treatment for severe sudden sensorineural hearing loss for at least 1 week

目的了解未规范治疗或治疗效果欠佳的、病程超过1周的、重度以上突发性聋的短期疗效。方法对住院的76例共77耳病程超过1周的重度以上突发性聋患者的临床资料进行回顾性分析。根据入院前听阈均值(pure tone average,PTA)分为重度聋组(35耳)、极重度聋组(31耳)及全聋组(11耳),按发病至入院时间将3组又分为7-13、14-29、≥30 d亚组,对各组的预后进行比较。结果重度聋组、极重度聋组、全聋组治疗后PTA改善分别为(17.3±13.6)、(21.0±17.7)、(12.4±9.1)dB,治疗前后PTA差异均有统计学意义(P<0.05),但组间PTA改善差异无统计学意义(P>0.05);PTA≤50 dB的百分率分别是37.1%、12.9%、0,组间差异有统计学意义(P<0.05)。重度聋组7-13、14-29、≥30 d PTA≤50 dB的百分率分别为44.4%、14.3%、20.0%,极重度聋组分别是16%、0、0,而全聋组均为0。结论对未规范治疗或治疗效果欠佳的病程超过1周的重度与极重度突发性聋患者进行治疗仍有意义,但全聋及病程超过2周的重度以上突发性聋患者疗效欠佳。

Objective To investigate and analyze the significance of treatment in severe sudden sensorineural hearing loss（SSNHL） patients,with no standard treatment or poor treatment effect for at least 1 week.Methods A total of 76 SSNHL patients（77 ears） with pure tone average（PTA） threshold over 70 dB for at least 1 week admitted in our department from January 2011 to April 2013 were enrolled and retrospectively analyzed in this study.According to their hearing threshold,they were divided into severe（35 ears）,profound（31 ears） and total SSNHL groups（11 ears）,and the 2 former groups were further assigned into 7-to 13-day,14-to 29-day,and ≥30-day groups by times from the onset to hospitalization.The outcome and prognosis of these groups were reviewed and compared.Results The improvement in PTA threshold was 17.3 ± 13.6,21.0 ± 17.7,and 12.4 ± 9.1 dB,respectively for the severe,profound and total SSNHL groups,and the differences were statistically significance in all groups before and after treatment（P 0.05）,but no difference was found among the 3 groups（P 0.05）.After therapy,the percentage rate with PTA ≤50 dB was 37.1%,12.9%,and 0,respectively in the severe,profound and total SSNHL groups,with significant difference among them（P 0.05）.After therapy,the percentage of severe SSNHL groups with PTA ≤50 dB lasting for 7 to 13 d,14 to 29 d,≥30 d were 44.4%,14.3%,and 20%,respectively,and the rates were 16%,0,and 0 in profound SSNHL.And that of SSNHL group was 0.Conclusion For the patients with severe or profound SSNHL under poor or non-standard treatment for more than 1 week,proper treatment is still beneficial.However,the outcome may be not good for the patients with total SSNHL for more than 1 week and serve-above SSNHL for more than 2 weeks.