704例突发性耳聋疗效分析

Therapeutic outcome analysis of 704 cases of sudden deafness

目的分析不同听力损失程度及听力曲线类型患者的疗效,为突发性耳聋的临床治疗提供参考。方法以2015年1月至2018年12月于广州中医药大学附属中山中医院耳鼻咽喉科住院治疗且确诊及临床资料完整的704例(805耳)突发性耳聋患者为研究对象,对比分析不同听力损失程度的不同听力曲线类型突发性耳聋患者的疗效。结果 172例低频下降型患者中,轻度与中度的痊愈率分别为64.66%、53.33%,差异无统计学意义(χ~2=0.122,P=0.727),总有效率分别为78.66%、73.33%,差异无统计学意义(χ~2=0.012,P=0.913);205例高频下降型患者中,轻度、中度、中-重度、重度者痊愈率分别为5.98%、4.34%、0、0,不同程度听力损失者的痊愈率差异无统计学意义(χ~2=2.636,P=0.451),轻度、中度、中-重度、重度者总有效率分别为22.22%、19.56%、38.46%、40.00%,不同程度听力损失者的总有效率差异无统计学意义(χ~2=5.067,P=0.167);226例平坦下降型患者中,轻度、中度、中-重度、重度者痊愈率分别为34.14%、4.76%、10.44%、9.21%,轻度与中度、中重度及重度间差异有统计学意义(χ~2=9.325、6.956、7.852,P=0.007、0.021、0.013),轻度、中度、中-重度、重度者总有效率分别为57.44%、37.09%、50.74%、52.63%,不同程度听力损失者的总有效率差异无统计学意义(χ~2=4.103,P=0.129);101例全聋型患者中,重度与极重度的痊愈率分别为12.50%、1.07%,差异有统计学意义(χ~2=4.954,P=0.026),重度与极重度者的总有效率分别为62.50%,34.40%,差异无统计学意义(χ~2=2.504,P=0.114)。结论听力损失程度对突发性聋的疗效有重要影响,除低频下降型外,其余听力曲线类型疗效均较差。

Objective To analyze the therapeutic outcome based on the hearing loss level and hearing curve in sudden deafness and to provide clinical treatment strategies.Methods In total,704 patients(805 ears)with sudden deafness hospitalized in the Otorhinolaryngology Department of Zhongshan Hospital of Traditional Chinese Medicine from January2015 to December2018 were selected for the study.The therapeutic outcomes based on the hearing loss level and hearing curve in sudden deafness were compared and analyzed.Results Among172 cases of low frequency hearing loss,the recovery rates of cases involving mild and moderate deafness were64.66%and53.33%,respectively,with no significant differences(χ~2=0.122;P=0.727),and the total effective rates were78.66%and73.33%,respectively,with no significant differences(χ~2=0.012;P=0.913).Among205 cases involving high frequency hearing loss,the recovery rates of cases involving mild,moderate,moderate-severe,and severe deafness were5.98%,4.34%,0%,and0%,respectively,with no significant differences(χ~2=0.012;P=0.913),and the total effective rates were22.22%,19.56%,38.46%,and40.00%,respectively,with no significant differences(χ~2=5.067;P=0.167).Among226 cases of flat hearing loss,the recovery rates of those with mild,moderate,moderate-severe,and severe deafness were34.14%,4.76%,10.44%,and9.21%,respectively,with no significant differences(χ~2=9.325,6.956,and7.852,respectively;P=0.007,0.021,and0.013,respectively),and the total effective rates were57.44%,37.09%,50.74%,and52.63%,respectively,with no significant differences(χ~2=4.103;P=0.129).Among101 cases of total deafness,the recovery rates of cases involving severe and extremely severe deafness were12.50%and1.07%,respectively,which was statistically significant(χ~2=4.954;P=0.026),and the total effective rates were62.50%and34.40%,respectively,with no significant differences(χ~2=2.504;P=0.114).Conclusions The degree of hearing loss is a factor influencing the therapeutic outcome in sudden deafness.Except for low frequency hearing loss,all other types showed a poor therapeutic outcome.