突发性聋伴良性阵发性位置性眩晕患者的预后观察

Treatment outcome of patients with idiopathic sudden sensorineural hearing loss and concomitant benign paroxysmal positional vertigo

目的:探讨突聋伴良性阵发性位置性眩晕(BPPV)患者的预后。方法:252例突聋患者中96例伴眩晕,加行眼震电图检查。将全部患者分为3组:突聋不伴眩晕组156例,突聋伴非BPPV眩晕组70例,突聋伴BPPV组26例。全部患者经静脉滴注尿激酶20万U、10万U各3d,同时静脉滴注银杏叶制剂及维生素B6,肌肉注射维生素B1、B12,治疗疗程2周。眼震电图行变位试验确诊为BPPV的26例患者进行手法复位治疗。结果:突聋伴BPPV组眩晕症状均治愈;在治疗后听力改善显效率上,突聋不伴眩晕组与突聋伴BPPV组无明显差异,但突聋伴非BPPV眩晕组明显低于其他2组。结论:突聋伴BPPV患者在听力及眩晕两个症状方面的预后相对良好。

To evaluate the treatment outcome of patients with idiopathic sudden sensorineural hear- ing loss （ISSHL） with concomitant benign paroxysmal positional vertigo （BPPV）. Method：Out of 252 ISSHL pa- tients, 96 patients were diagnosed with complicating vertigo and examined using electronystagmography. All pa- tients were divided into three groups, namely, ISSHL without vertigo group （n= 156）, ISSHL with non-BPPV vertigo group （n=70） and ISSHL with BPPV group （n=26）. All patients received daily intravenous infusion of 200 000 U urokinase for 3 consecutive days and 100000 U for 3 additional days. Concomitant medications included intravenous Ginkgo biloba leave compound and vitamin B6 and intramuscular vitamins B1 and B12 for 2 weeks. Twenty-six patients diagnosed with BPPV on electronystagmography positioning test also received canalith reposi- tioning maneuver. Result. Vertigo-associated symptoms completely resolved after canalith repositioning maneuver in ISSHL patients with complicating BPPV. With respect to post-treatment hearing, ISSHL patients without vertigo exhibited a similar improvement as compared to those with BPPV, while those with non-BPPV vertigo had a sig- nificantly less improvement than those without vertigo and with BPPV. Conclusion：ISSHL patients with complica- ting BPPV exhibit a relatively favorable outcome with respect to hearing and vertigo-associated symptoms after medical and repositioning treatment.