高压氧综合治疗平坦型突发性聋临床疗效分析

Clinical evaluation of comprehensive hyperbaric oxygen therapy in the treatment of flat type sudden hearing loss

目的 观察高压氧（hyperbaric oxygen,HBO）治疗平坦型突发性聋（sudden hearing loss,SHL）的疗效.方法 对71例经HBO治疗1次/d,10 d为1个疗程的平坦型SHL患者进行回顾性分析.经常规治疗无效后采用HBO治疗44例,为对照组;在初始治疗时即采用HBO治疗27例,为HBO组.将治疗前后4个频率（500、1 000、2 000、4 000 Hz）气导纯音听阈均值（PTAs）及疗效进行比较分析.结果对照组治疗前后PTAs分别为（59.50±10.58） dB HL和（39.18±18.95） dB HL,差异有统计学意义（P＜0.05）;观察组治疗前后PTAs分别为（60.81±10.40）dB HL和（31.89±16.24）dB HL,差异有统计学意义（P＜0.05）.2组治疗后总有效率分别为61.36％和81.48％,差异有统计学意义（t=8.566,P＜0.05）.2组患者发病至HBO开始治疗时间分别为（16.32 ±3.65）d和（9.07 ±6.85）d,2组比较差异有统计学意义（P＜0.05）;其中对照组中＞14d为53.33％（30/44）,观察组中≤14 d为90.0％（20/27）,差异有统计学意义（P＜0.05）.将HBO开始治疗时间与疗效行Spearman相关性分析,治疗时间与疗效呈正相关（r=0.434,P＜0.05）.结论 HBO治疗应该作为综合治疗手段之一用于平坦型SHL的治疗,而且越早治疗效果越好.

Objective To observe the clinical efficacy of hyperbaric oxygen （HBO） in the treatment of flat type sudden hearing loss （SHL）.Methods A retrospective analysis was made on 71 cases of flat type SHL treated with HBO.The patients were treated with HBO once a day,10 days a treatment course.Pure-tone averages （PTAs） at 4 frequencies （500,1 000,2 000,4 000 Hz） were compared before and after HBO therapy,and therapeutic efficacy was analyzed.Results Forty-four patients （the invalid group） began HBO therapy,when conventional treatment was invalid.PTAs before and after HBO therapy were respectively （59.50 ± 10.58） dB HL and （39.18 ± 18.95） dB HL,and statistical significance could be noted,when comparisons were made between them （P 〈 0.01）.Twenty-seven patients （the initial group） received HBO therapy at the initial treatment stage.PTAs for the patients of this group before and after HBO therapy were respectively （60.81 ± 10.40） dB HL and （31.89 ± 16.24） dB HL,and there was statistical significance,when comparisons were made between them （P 〈 0.01）.Total efficacy rates for the 2 groups after treatment were respectively 61.36% and 81.48%,and statistical significance could be seen,when comparisons were made between them（t =8.566,P 〈 0.01）.The treatment time from the onset to HBO therapy for the patients of the 2 groups was （16.32 ± 3.65） days and （9.07 ± 6.85） days respectively,and statistical significance could be noticed,when comparisons were made between the 2 groups （P 〈0.01）.The treatment time from the onset to HBO therapy for the invalid group was 〉 14 days,accounting for 53.33% of the patients treated（30/44）,while the treatment time from the onset to HBO therapy for the initial group was ≤ 14 days,accounting for 90.0% （20/27）,and statistical significance could also be noted,when comparisons were made between the 2 groups（P 〈 0.01）.When correlative analyses were made between HBO initiation time and effective rate,it could be seen that HBO initiation time was positively correlated with treatment efficacy （r =0.434,P 〈 0.01）.Conclusions HBO therapy could be used as one of the methods in the comprehensive treatment of flat type SHL,and the earlier HBO treatment was implemented,the better the results.