妊娠期突发性聋的临床特点及预后

Clinical characteristics and prognosis of idiopathic sudden sensorineural hearing loss during pregnancy

目的分析妊娠期突发性聋的临床特点及预后,并探讨其治疗方案,提高临床医师对该病的认识。方法收集2013年1月～2017年1月在南华大学附属第一医院诊断并住院治疗的16例妊娠期突发性聋患者的一般临床资料。16例患者均为单侧发病,左侧8耳,右侧8耳; 3例妊娠早期发病,7例妊娠中期发病,6例妊娠晚期发病; 10例伴有耳鸣,4例伴有眩晕,患者入院平均听阈为(64. 45±27. 83) d BHL,所有患者入院后均予低分子右旋糖酐静脉滴注及鼓室内注射地塞米松治疗。结果治疗后平均听阈为(46. 48±29. 81) d BHL,平均听阈改善值为(17. 34±15. 70) d BHL,与治疗前比较差异具有统计学意义(P <0. 05)。痊愈5耳,显效2耳,有效6耳,无效3耳。结论妊娠期突发性聋常发病于妊娠中晚期,听力损失较重且常伴有耳鸣,听力曲线以全聋型和平坦型为主;给予鼓室内注射地塞米松联合低分子右旋糖酐静脉滴注治疗安全有效。

Objective To analyze the clinical characteristics and prognosis of sudden sensorineural hearing loss（SSNHL）during pregnancy,and investigate the therapeutic regimen as well as improve the understanding of this disease.Methods Clinical data of 16 SSNHL patients during pregnancy treated in our hospital between Jan 2013 and Jan 2017were analyzed retrospectively.Hearing loss occurred unilaterally in all patients with equal numbers on both sides.Of them,3（18.75%）were in the first trimester,7（43.75%）in second trimester and 6（37.50%）in last trimester.10 patients（62.50%）were accompanied with tinnitus and 4（25.00%）with vertigo.Their initial average hearing threshold was（64.45±27.83）d BHL.All patients were treated with intravenous drip of dextran-40 and intratympanic injection of corticosteroid.Results The average hearing threshold after treatment was（46.48±29.81）d BHL with an improvement of（17.34±15.70）d BHL,and the difference of average hearing threshold before and after treatment was statistically significant（P〈0.05）.As for the therapeutic effect,complete recovery was achieved in 5 ears（31.25%）,significant recovery in 2（12.50%）,partial recovery in 6（37.50%）and no effect in 3（18.75%）.ConclusionsSSNHL in pregnancy usually occurs in the second trimester or the last trimester with severe hearing loss accompanied by tinnitus,and the hearing loss is total deafness and flat type predominately.Combination of intravenous drip of dextran-40 with intratympanic injection of corticosteroid is effective and safe for the treatment of SSNHL during pregnancy.