前庭康复在突发性聋伴眩晕治疗中的疗效分析

Therapeutic effect of vestibular rehabilitation on sudden deafness with vertigo

目的分析突发性聋伴眩晕患者的眩晕症状在药物联合前庭康复治疗后的疗效。方法将52例单耳突发性聋伴眩晕的住院患者随机分为研究组和对照组,入院后完善纯音测听、前庭功能检查(冷热试验、视频头脉冲试验(video-head impulsive test,VHIT)、眩晕障碍量表(dizziness handicap inventory,DHI)。两组患者根据不同类型听力曲线进行相应药物治疗,同时研究组进行前庭康复治疗,通过DHI量表评估眩晕改善情况。结果 52例突发性聋伴眩晕,34.62%为轻中度听力下降,65.38%为重度及极重度听力下降;71.15%患者有半规管功能减弱;治疗2周时,两组患者同组内分别与治疗前比较(t研究组=18.42,t对照组=11.55,P均<0.05);治疗4周时,两组患者同组内分别与治疗2周时比较(t研究组=6.34,t对照组=6.76,P均<0.05)。两组间治疗2周时比较(t=6.07,P<0.05)和两组间治疗4周时比较(t=12.14,P<0.05)DHI评分差异性均具有统计学意义。结论突发性聋伴眩晕的听力损失以重度及极重度为主;前庭功能可表现为正常或减退;前庭康复治疗能有效改善突发性聋伴眩晕患者的眩晕症状,加快眩晕患者恢复。

OBJECTIVE To observe the therapeutic effect of medications combined with vestibular rehabilitation on the vertigo symptom in sudden deafness with vertigo. METHODS Fifty-two hospitalized patients with monaural sudden deafness and vertigo were randomized into study group and control group. After admission, the pure-tone audiograms and vestibular function tests (caloric test, video Head impulse test VHIT) and vertigo disorder scales (DHI) were performed. The two groups of patients were treated with medications according to different types of sudden deafness and at the same time, the study group was treated with vestibular rehabilitation. The degree of vertigo was assessed by the DHI scales. RESULTS Of all the 52 cases, 34.62 % of patients with vertigo with mild to moderate hearing loss, 65.38% of patients with vertigo with severe to profound sensorineural deafness;71.15% of patients with sudden onset of vertigo had impaired semicircular canal function;The DHI scores reduced compared with before treatment(P<0.05), and all had significant differences between the groups after 2 and 4 weeks of treatment(P<0.05). CONCLUSIONThe degree of hearing loss of sudden deafness with vertigo is severe, mainly with severe and profound hearing loss. The vestibular function test can be normal or abnormal. The vestibular rehabilitation therapy for vertigo in patients with sudden deafness are effective and can significantly improve clinical outcomes and the quality of life of these patients.