尿毒症合并突发性聋患者的临床特征及预后

Clinical characteristics and prognosis of uremia patients with sudden deafness

摘要:

目的 分析尿毒症合并突发性聋（突聋）患者的临床特征及预后。方法 收集2015年1月—2019年12月在会理县人民医院治疗的尿毒症合并突聋患者29例（30耳），平均初诊听阈值为（62.33±13.68） dB HL；17耳（56.67%）伴耳鸣，8耳（26.67%）伴眩晕；9耳（30.00%）为平坦型，13耳（43.33%）为全聋型。根据尿毒症病程长短将29例患者分为<2年组（13例，13耳）、2～4年组（8例，8耳）和>4年组（8例，9耳），对比3组突聋患者的听力预后。结果 29例（30耳）患者治疗结束3个月后，3耳（10.00%）痊愈、5耳（16.67%）显效、6耳（20.00%）有效、16耳（53.33%）无效，平均听阈改善均值为（15.68±7.43） dB HL。根据尿毒症病程长短分组后，尽管<2年组、2～4年组和>4年组的痊愈率、显效率、有效率和无效率无统计学差异，但3组的听阈改善值分别为（20.52±7.95）、（16.30±6.27）、（7.78±9.36） dB HL，组间比较差异具有统计学意义（P<0.05）。结论 尿毒症合并突聋的患者听力损失较重，听力预后较差，尿毒症病程越长预后越差。

Abstract:

Objective To analyze the clinical characteristics and prognosis of uremia patients with sudden deafness. Methods Twenty-nine patients (30 ears) were collected, who had uremia complicated sudden deafness treated in Huili County People's Hospital from January 2015 to December 2019. The average threshold of initial hearing in the 29 patients were (62.33±13.68) dB HL. And 17 ears (56.67%) of the 30 ears were accompanied with tinnitus, 8 ears (26.67%) of the 30 ears were accompanied with vertigo;9 ears (30.00%) of the 30 ears exhibited flat-type hearing loss and 13ears (43.33%) of the 30 ears were completely deaf. According to the duration of uremia, the 29 patients were divided into <2 years group (13 cases, 13 ears), 2~4 years group (8 cases, 8 ears) and 4 years group (8 cases, 9 ears). And the hearing recovery was compared among three groups. Results Three months after the end of treatment for the 29 patients(30 ears), 3 ears (10.00%) were cured, 5 ears (16.67%) were significantly effective, 6 ears (20.00%) were effective, and 16 ears (53.33%) were ineffective. The average improvement of hearing threshold was (15.68±7.43) dB HL. There were no significant differences in cure rate, significant efficiency, effective rate and inefficiency in <2 years group, 2~4 years group and 4 years group according to the duration of uremia. The improvement of hearing threshold in the three groups was (20.52±7.95), (16.30±6.27) and (7.78±9.36) dB HL, respectively, and the difference between groups was statistically significant (P<0.05). Conclusion Patients with uremia complicated with sudden deafness often suffer from severe hearing loss, and the hearing recovery is poor. The longer the course of uremia, the worse the prognosis.