双侧突发性耳聋疗效的影响因素分析

Analysis of the Influencing Factors of Therapeutic Effect of Sudden Bilateral Sensorineural Hearing Loss

目的:探讨影响双侧突发性耳聋疗效的因素。方法:回顾性分析2011年2月至2013年5月我科收治的24例(48耳)双侧突发性耳聋的病例资料。其中,男性18例(75.0%),女性6例(25.0%)。年龄14-72岁,平均年龄49.3岁。按照听力曲线分型,低中频下降型0耳(0.0%),中高频下降型16耳(33.3%),平坦型18耳(27.5%),全聋型14耳(29.2%)。分析和比较具有不同听力曲线分型、伴发症状、年龄、伴发疾病、听力损失程度、发病至干预时间的双侧突发性耳聋患者总有效率的差异。结果:具有不同听力曲线类型、发病至干预时间、听力损失程度以及是否伴有高血压、糖尿病、高血脂、眩晕症状的双侧突发性耳聋患者的总有效率比较差异均无统计学意义(P>0.05)。伴发耳鸣的双侧突发性聋患者治疗总有效率显著高于不伴发耳鸣患者,差异有统计学意义(P<0.05)。年龄≤60岁的双侧突发性耳聋患者的治疗总有效率显著高于年龄>60岁者(P<0.05)。结论:伴发耳鸣、年龄小于60岁的双侧突发性耳聋患者的治疗效果相对较好,而听力曲线类型、听力损失程度、发病至干预时间、是否伴发眩晕症状与其治疗效果均无关。

Objective： To investigate the influencing factors of therapeutic effect of sudden bilateral sensorineural hearing loss. Methods： 24 cases（48 ears） with sudden bilateral sensorineural hearing loss admitted in our department from February 2011 to May 2013 were retrospectively analyzed. 24 patients （48 ears） were recruited including 18 male cases （75.0%） and 6 female cases （25.0%）. The average age was 49.3 years. The patients were divided into 4 types according to their audiometric curve： No one was acute sensorineural hearing loss（SNHL） in low tone frequencies, 16 ears were acute SNHL in high tone frequencies（33.3%）, 18 ears were acute SNHL in all frequencies （PTA〈 80 dB HL）（27.5%） and 14 ears were profound SNHL in all frequencies （PTA~ 81 dB HL）（29.2%）. The therapeutic effects of different types of audiometric curve, accompanied symptoms, ages, accompanied diseases, degree of hearing loss and interval from onset to intervention were analyzed. Results： There was no significant difference in the curative rate among different types, interval from onset to intervention, accompanied diseases, with and without vertigo of patients with sudden bilateral sensorineural hearing loss （P〉0.05）. However, the efficacy of patients with tinnitus or age〉60 years old were significantly higher（P〈0.05）. Conclusion＂ The patients of sudden bilateral sensorineural hearing loss who accompanied with tinnitus and was less than 60 years old had better prognosis, the prognosis of sudden bilateral sensorineural hearing loss was not related to the type of audiometric curve, degree of hearing loss, interval from onset to intervention, and accompanied with vertigo.