儿童突发性聋患者的预后分析

Prognostic factors of sudden sensorineural hearing loss in children

目的：分析儿童突发性聋患者的疗效及影响突发性聋预后的相关因素,以指导临床诊断和治疗。方法：本文选取2010-11-2015-05期间在解放军总医院耳内科住院治疗的0-18岁有较完整临床资料的101例（113耳）儿童突发性聋患者的资料,对其治疗效果进行回顾性研究,分析儿童突发性聋患者的性别、初诊时间、听力损失程度、是否伴发眩晕、耳鸣等相关因素对预后的影响。结果：101例（113耳）儿童突发性聋患者中,男60耳,女53耳;单耳发病89耳,双耳发病24耳;发病至就诊时间1-183d,平均（18.5±22.1）d。8耳（7.1%）为轻度听力损失,7耳（6.2%）为中度听力损失,27耳（23.9%）为重度听力损失,71耳（62.8%）为极重度听力损失。伴发耳鸣症状者88耳（77.9%）,伴发眩晕症状者62耳（54.9%）。经系统治疗后痊愈11耳（9.7%）,总有效率为36.3%。对儿童突发性聋的相关因素进行统计学分析,其中听力损失程度,初诊时间,性别,侧别对疗效的影响有统计学意义（P〈0.05）。结论：儿童突发性聋患儿一般听力损失重;但经积极及时的治疗后,仍有好转甚至痊愈的可能。初诊时间越短、听力损失程度越轻者疗效较好;单侧聋患者较双侧聋患者疗效好;女性患者较男性患者疗效好。是否伴发耳鸣、眩晕,ABR及DPOAE是否引出对儿童突发性聋的预后无明显的影响。

Objective：The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children,and explore the prognostic factors in order to guide the clinical diagnosis and treatment.Method：A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5years（from November 2010 to May 2015）in Chinese PLA General Hospital.This paper have a complete clinical data of 101patients（113ears）with sudden hearing loss,ranging from 0to 18 years old.Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed.Result：Among 101patients（113ears）,the ratio of male and female was 60：53.Treatment was initiated from 1to 183 days after disease onset,with an average of（18.5±22.1）d.Bilateral and unilateral hearing loss were 24 ears and 89 ears,respectively.The proportion of mild hearing loss,moderate hearing loss,severe hearing loss and profound hearing loss were 7.1%,6.2%,23.9% and 62.8%,respectively.Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients,respectively.After the treatment,the complete recovery rate was9.7% and the overall recovery rate was 36.3%.The degree of hearing loss,earlier treatment onset,sex and bilateral involvement were significantly associated with hearing recovery（P〈0.05）.Conclusion：Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss,but after positive and timely treatment,it can be improved or even cured.The mild hearing loss,earlier treatment onset,unilateral hearing loss and female were positive prognostic factors.The concurrence of tinnitus or vertigo,the results of ABR and DPOAE had no significant influence on prognosis.