视频眼震电图对突发性聋伴眩晕患者前庭功能的诊断价值分析

Diagnostic value of video nystagmography for vestibular function evaluation in patients with sudden deafness and vertigo

摘要:

目的探讨视频眼震电图对突发性聋伴眩晕患者前庭功能的诊断价值。方法将2013年2月~2017年12月收纳的500例突聋患者作为研究对象，根据是否合并眩晕分为眩晕组（180例）和非眩晕组（320例），所有患者入院后进行纯音听力测试、视频眼震电图（videonystagmograph，VNG）检测等，比较眩晕组和非眩晕组患者纯音测听和视频眼震电图检测结果，同时统计患者平坦型、全聋型、低频型、中频型、高频型的听力曲线例数及冷热试验的前庭功能评价结果，并比较组间差异。患者根据视频眼震电图和相关检测结果进行对应治疗，统计两组患者的治疗效果。结果①眩晕组患者的前庭功能正常比例（48.9%）显著低于非眩晕组（83.8%）（P＜0.05）；听力学结果显示听力损失严重者比例（67.2%）显著高于非眩晕组（28.1%），轻度患者比例（8.3%）明显低于非眩晕组（40.0%）（P均＜0.05）；②患者的听力曲线主要有平坦型108例，其中前庭功能异常15例（13.9%）；全聋型78例，其中前庭功能异常34例；低频型100例，其中前庭功能异常28例（28.0%）；中频型94例，其中前庭功能异常25例（26.6%）；高频型120例，其中前庭功能异常42例（35.0%）。表明全聋型曲线前庭功能异常率显著高于其他类型听力曲线患者，冷热试验结果表明前庭功能异常的主要表现为半规管轻瘫；③两组患者临床疗效其中眩晕组患者显效率26.7%（48/180）、有效率28.9%（52/180）及总有效率55.6%（100/180）明显低于非眩晕组的38.1%（122/320）、45.6%（146/320）及83.7%（268/320）（P均＜0.05）。结论突发性聋伴眩晕患者前庭功能受到明显损伤，采用视频眼震电图进行前庭功能检测对突发性聋伴眩晕患者的病情评估、诊断、治疗具有重要指导意义，值得临床借鉴。

关键词:突发性聋|眩晕|前庭功能|视频眼震电图

Abstract:

ObjectiveTo explore the diagnostic value of video nystagmography(VNG) for vestibular function in patients with sudden deafness and vertigo.Methods500 patients with sudden deafness hospitalized in our department between Feb. 2013 and Dec. 2017 were divided into vertigo group (n=180) and nonvertigo group (n=320). Pure tone audiometry and VNG were performed to all the patients. The results of both groups were compared. Meanwhile, the case numbers of flattype hearing loss, total hearing loss, lowfrequency loss, medialfrequency loss and highfrequency loss according to the audiogram were counted, and their vestibular functions were evaluated via caloric test. All the results were compared. The patients received corresponding treatment according to the results of VNG and correlative examinations, and the therapeutic effect of the two groups was compared.Results①The proportion of patients with normal vestibular function in vertigo group (48.9%) was significantly lower than that in nonvertigo group (83.8%)(P<0.05). The proportion of patients with severe hearing loss in vertigo group (67.2%) was significantly higher than that in nonvertigo group (28.1%)(P<0.05), and the proportion of patients with mild hearing loss (8.3%) was significantly lower than that in nonvertigo group (40.0%)(P<0.05). ②Pure tone audiometry revealed flattype hearing loss in 108 cases including 15 (13.9%) with abnormal vestibular function, total hearing loss in 78 cases including 34 (43.6%) with abnormal vestibular function, lowfrequency loss in 100 cases with abnormal vestibular function in 28 (28%), medialfrequency loss in 94 cases with abnormal vestibular function in 25 (26.6%), and highfrequency loss in 120 including 42 (35.0%) with abnormal vestibular function. The results showed that the rate of vestibular dysfunction in the patients with total deafness curve was significantly higher than those with other types of hearing curves. The caloric test showed that vestibular dysfunction was mainly displayed by hemispheric canal paralysis. ③The marked effective, effective and total effective rates of the vertigo group were 26.7%(48/180), 28.9%(52/180) and 55.6% (100/180) respectively, which were all significantly lower than those of the nonvertigo group (38.1%, 45.6% and 83.7%)(all P<0.05).ConclusionObviously damaged vestibular function presents in sudden deafness patients with vertigo. The vestibular function detection by VNG is of great significance to the evaluation, diagnosis and treatment of sudden deafness and vertigo, and worthy of clinical reference.

Key words:Sudden deafness| Vertigo|Vestibular function|Video nystagmography