天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (3): 264-268.doi: 10.11958/20171020

• 临床研究 • 上一篇    下一篇

高压氧联合地塞米松治疗突发性耳聋的疗效及相关影响因素分析

胡海艳，施丽琴   

  1. 上海市浦东新区人民医院高压氧科（邮编201299）
  • 收稿日期:2017-10-09 修回日期:2018-01-08 出版日期:2018-03-15 发布日期:2018-03-23
  • 通讯作者: 施丽琴 E-mail:shiliqin1971@163.com

The curative effect and related influencing factors of hyperbaric oxygen combined with dexamethasone in the treatment of sudden deafness

HU Hai-yan, SHI Li-qin   

  1. Department of Hyperbaric Oxygen, People’s Hospital of Shanghai Pudong New District, Shanghai 201299, China
  • Received:2017-10-09 Revised:2018-01-08 Published:2018-03-15 Online:2018-03-23

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摘要： 目的 分析高压氧联合地塞米松治疗突发性耳聋（SD）的疗效及相关影响因素。方法 回顾性分析 2014年 1 月—2016 年 12 月我院 200 例采用高压氧联合地塞米松治疗的 SD 患者的临床资料，根据疗效分为有效组（n=182 例）与无效组（n=18 例），比较 2 组性别、年龄、发病至就诊时间、耳别、听力损失、听力曲线类型、伴眩晕情况、伴耳鸣情况、合并疾病（高血压或糖尿病）、血浆黏度及血清 C 反应蛋白（CRP）等指标，并采用 Logistic 回归筛选影响SD 疗效的危险因素。结果 200 例患者经治疗后，总有效 182 例（91.00%），无效 18 例(9.00%）。有效组年龄>50岁、发病至就诊时间>7 d、听力损失≥60 dB、听力曲线类型为高频型或全聋型、伴眩晕、合并高血压、合并糖尿病、血浆黏度≥2 mPa·s、血清 CRP≥20 μmol/L 的比例明显低于无效组（P＜0.05）。Logistic 回归分析显示，年龄（>50 岁）、发病 至就诊时间（>7 d）、听力损失（≥60 dB）、听力曲线类型为高频型或全聋型、伴眩晕、合并高血压、合并糖尿病、血浆黏度（≥2 mPa·s）、血浆 CRP（≥20 μmol/L）为影响 SD 疗效的危险因素（P＜0.05）。结论 高压氧联合地塞米松是治疗SD 的有效方案，但影响其疗效的因素众多，临床治疗时有必要考虑患者临床与病理特征。

关键词: 高压氧, 地塞米松, 临床方案, 因素分析, 统计学, 突发性耳聋

Abstract: Objective To analyze the curative effect and related influencing factors of hyperbaric oxygen combined with dexamethasone in the treatment of sudden deafness (SD). Methods The clinical data of 200 patients with SD, who were treated with hyperbaric oxygen combined with dexamethasone in our hospital from January 2014 to December 2016, were retrospectively analyzed. According to the curative effect, patients were divided into the effective group (n=182) and the ineffective group (n=18). Data of gender, age, time from onset to treatment, ears, hearing loss, the type of audiometric curve,dizziness, tinnitus, complications (hypertension or diabetes), plasma viscosity and serum C reactive protein(CRP) were compared between the two groups. Logistic regression analysis was used to screen risk factors influencing the curative effect of SD. Results The total response rate was 91.00% (182/200), and the ineffective rate was 9.00% (18/200). In the effective group patients aged > 50 years old, the time from onset to treatment was > 7 d, and the hearing loss was ≥ 60 dB. The proportions of high-frequency or stone-deaf audiometric curves, combined with dizziness, hypertension, diabetes, plasma viscosity ≥ 2 mPa·s and serum CRP level ≥ 20 μmol/L were significantly lower in the effective group than those in the ineffective group (P＜0.05). Logistic regression analysis showed that age (> 50 years old), time from onset to treatment (> 7 d),hearing loss (≥ 60 dB), high-frequency or stone-deaf audiometric curves, combined with dizziness, hypertension, diabetes,plasma viscosity (≥2 mPa·s) and plasma CRP (≥20 μmol/L) were high risk factors for the curative effect of SD (P＜0.05).Conclusion Hyperbaric oxygen combined with dexamethasone is an effective treatment for SD, but there are many factors affecting the curative effect. It is necessary to consider the clinical and pathological characteristics of patients in clinical treatment.

Key words: hyperbaric oxygenation, dexamethasone, clinical protocols, factor analysis, statistical, sudden deafness