各年龄段全聋型特发性突聋的临床分析

Outcomes of total deafness type of idiopathic sudden deafness in different ages

目的：研究各年龄段全聋型特发性突聋的临床预后。方法：179例全聋型特发性突聋患者,根据年龄将患者分为5组,即儿童组（≤13岁）、青年组（14-44岁）、中年组（45-59岁）、老年前期组（60-74岁）、老年组（≥75岁）。根据初始听力损失程度分为3组：81dB组（81-89dBHL）、90dB组（90-99dBHL）、100dB组（≥100dBHL）。常规综合治疗方法包括糖皮质激素、改善内耳微循环类药物、神经营养药物、饱和氧及高压氧治疗等,根据年龄及体重用药。结果：青年组患者（83/179,46.4%）最多（P〈0.05）,其次为中年组（57/179,31.8%）（P〈0.05）,再次为老年前期组（26/179,14.5%）（P〈0.05）,儿童组（8/179,4.5%）与老年组患者（5/179,2.8%）最少。全聋型患者中儿童组和老年组无痊愈者,其余组痊愈者均少。各年龄组全聋型突聋疗效差异无统计学意义（P〉0.05）。全聋型突聋中,100dB组患者最多（108/179,60.3%）（P〈0.05）,81dB组（39/179,21.8%）与90dB组（32/179,17.9%）患者比例相近（P〉0.05）。81dB组突聋疗效（25/39,64.1%）与90dB组（18/32,56.2%）相近（P〉0.05）,81dB组与90dB组疗效均优于100dB组（24/108,22.2%）（P〈0.05）,100dB组的疗效降低了全聋型突聋的疗效。伴眩晕（95/179,53.1%）与不伴眩晕者（84/179,46.9%）比例相近（P〉0.05）,不伴眩晕者突聋疗效（43/84,51.2%）优于伴眩晕者（24/95,25.3%）（P〈0.05）。81dB组不伴眩晕者（31/39,79.5%）最多（P〈0.05）,90dB组（18/32,56.2%）次之（P〈0.05）,100dB组伴眩晕者最多（73/108,67.6%）（P〈0.05）。81dB组（21/31,67.7%）与90dB组不伴眩晕者（11/18,61.1%）突聋疗效相近（P〉0.05）,均优于100dB组不伴眩晕者（11/35,31.4%）疗效（P〈0.05）。结论：100dB组伴眩晕者最多,将全聋型突聋患者以100dB为分界,可获得预测显效率、愈合率、总有效率高低的重要预后信息。

Objective：This retrospective study was aimed to investigate the characteristics of hearing recovery in the complete deafness type of SSNHL（≥81dBHL）in patients with different ages.Method：Clinical outcomes of179 total deafness type of idiopathic sudden deafness were compared.Patients were divided into 5groups according to age,they were,pediatric group（13years or less）,youthful group（14-44years）,middle-aged group（45-59years）,presenium group（60-74years）,senectitude group（75years or higher）.Patients were divided into 3groups according to the initial degree of hearing loss：81 dB group（81-89 dBHL）,90 dB group（90-99dBHL）,100 dB group（100dBHL or higher）.Routine comprehensive treatment including corticosteroids,the inner ear microcirculation improvement drugs,neurotrophic drugs,saturationoxygen and hyperbaric oxygen therapy,etc.was applied.Patients were treated in accordance with the age and body weight.Result：The percentage of youthful group（83/179,46.4%）was highest（P〈0.05）,middle-aged group（57/179,31.8%）followed（P〈0.05）,presenium group（26/179,14.5%）was lower（P〈0.05）,pediatric group（8/179,4.5%）and senectitude group（5/179,2.8%）were the lowest.No a complete recovery in either pediatric group or senectitude group.A complete recovery was rare in the other groups.Recovery rate of the different aged groups was similar（P〉0.05）.The percentage of 100 dB group（108/179,60.3%）was highest（P〈0.05）.The percentage of 81 dB group（39/179,21.8%）was similar to 90 dB group（32/179,17.9%）（P〉0.05）.Recovery rate was similar in 81 dB group（25/39,64.1%）and 90 dB group（18/32,56.2%）（P〉0.05）.Recovery rate of both 81 dB group and 90 dB group weregreater than 100 dB group（24/108,22.2%）（P〈0.05）.The 100 dB group reduced the satisfactory recovery effects.There were no differences in the proportion of the patients with dizziness（95/179,53.1%）and without dizziness（84/179,46.9%）（P〉0.05）.Recovery rate of patients without dizziness（43/84,51.2%）was greater than with dizziness（24/95,25.3%）（P〈0.05）.The percentage of the patients without dizziness（31/39,79.5%）in81dB group was the highest（P〈0.05）,90 dB group（18/32,56.2%）followed（P〈0.05）.The percentage of the patients with dizziness in 100 dB group（73/108,67.6%）was highest（P〉0.05）.Recovery rate was similar in the patients without dizziness of 81 dB group（21/31,67.7%）and 90 dB group（11/18,61.1%）（P〈0.05）.Recovery rate of the above two groups was greater than that of 100 dB group（11/35,31.4%）（P〈0.05）.Conclusion：Recovery rate of the different aged groups was similar.The percentage of the patients with dizziness in 100 dB group was highest.Initial hearing threshold in excess of 100 dB reduced the satisfactory recovery in patients with total deafness type of SSNHL.Our results provided a good reference for other clinicians.