伴有眩晕或头晕重度以上突聋患者的临床疗效差异分析

Differential analyses of clinical features and efficacy of severe sudden deafness with vertigo or dizziness

摘要:

目的分析伴有眩晕或头晕重度以上突聋患者的临床疗效差异。方法选取2013年1月~2016年12月收治的重度以上突聋病例70例，其中不伴眩晕或头晕者（A组）30例，伴头晕者（B组）11例，伴眩晕者（C组）29例。3组患者均给予：①降低纤维蛋白原药物；②糖皮质激素；③改善内耳微循环药物治疗。比较3组临床疗效差异。结果治疗前A、B、C组患者平均听阈［分别为（86.88±10.19）、(98.58±9.28)、(96.84±8.81）dB］三者差异无统计学意义（P＞0.05）。治疗后A、B、C组患者平均听阈［分别为(60.73±26.06)、(89.33±18.70)、(85.99±19.23)dB］，三者比较差异具有统计学意义（P＜0.05），表明治疗后不伴眩晕或头晕组的平均听阈明显低于伴眩晕或头晕组。治疗后A、B、C组总有效率（分别为66.67%、36.37%、37.93%），三者差异具有统计学意义（P＜0.05），表明治疗后不伴眩晕或头晕组的总有效率明显高于伴眩晕或头晕组。治疗结束后A组痊愈率为30%，B、C组痊愈率为0；治疗出院3个月后随访时A、B、C组痊愈率分别为53.33%、18.18%、13.79%。治疗后与治疗出院3个月后随访时3组痊愈率比较，差异均具有统计学意义（P<0.05），表明治疗后不伴眩晕或头晕组的痊愈率明显高于伴眩晕或头晕组。患者出院时总痊愈率为12.86%，3个月后随访时总痊愈率为31.42%，两组痊愈率差异具有统计学意义（P＜0.05），表明出院后部分患者听力继续好转，且多为出院时有效或显效患者。结论重度以上突聋患者治疗后不伴眩晕或头晕组的平均听阈明显低于伴眩晕或头晕组，且治疗结束后及治疗出院3个月后随访时总有效率、痊愈率明显高于伴眩晕或头晕组，出院后患者听力仍可继续恢复至3个月达到稳定。

关键词:突聋|眩晕|头晕|疗效

Abstract:

Abstract:ObjectiveTo investigate the clinical characteristics and curative effects of severe sudden hearing loss with vertigo or dizziness.MethodsFrom Jan 2013 to Dec 2016, 70 patients with severe sudden deafness were hospitalized in our department. Of them, 30 were unaccompanied by vertigo/dizziness (Group A), 11 were accompanied by dizziness (Group B) and 29 by vertigo (Group C). All the patients in the three groups had the same drug treatment including fibrinogen lowering drugs, glucocorticoids and microcirculation improving drugs. The curative effects among the three groups were compared.ResultsBefore treatment, the differences of pure tone average (PTA) among the three groups［(86.88±10.19)dB,(98.58±9.28)dB and (96.84±8.81)dB］ respectively were statistically insignificant (all P>0.05). After treatment, the differences of PTA among the three groups［(60.73±26.06)dB,(89.33±18.70)dB and (85.99±19.23)dB］ respectively were statistically significant (all P<0.05), which indicated that the PTA of patients without vertigo/dizziness was significantly lower than those with vertigo or dizziness. After treatment, the differences of total effective rates among the three groups (66.67%, 36.37% and 37.93% respectively) were statistically significant (all P<0.05). The total effective rate of patients without vertigo/dizziness was significantly higher than those with vertigo or dizziness. The cure rates of group A, B and C were 30%, 0% and 0%. Three months after treatment, the cure rates of them were 53.33%, 18.18% and 13.79% respectively. The differences of cure rates after the treatment and three months later among the three groups were all statistically significant (all P<0.05).For all the patients, the total cure rate was 12.86% after the treatment and 31.42% three months later, with a statistically significant difference (P<0.05). After discharge, the hearing got further improved in some patients, especially those with good and obvious therapeutic effect during their hospitalization.ConclusionThe PTA of severe sudden hearing loss patients without vertigo/dizziness is significantly lower than those with vertigo or dizziness. The total effective rates and the possibility of complete hearing recovery for patients without vertigo/dizziness are significantly higher than those with vertigo or dizziness. After discharge, their hearing may get further improved and stabilized in three months.

Key words:Sudden deafness|Vertigo| Dizziness