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高压氧联合治疗特发性突发性感音神经性听力损失患者的疗效及预后因素

Efficacy and Prognostic Factors of Combined Hyperbaric Oxygen Therapy in Patients With Idiopathic Sudden Sensorineural Hearing Loss.

作者信息

Wang Yong, Gao Yali, Wang Boxuan, Chen Liyan, Zhang Xiaoxiao

机构信息

Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China.

Department of Otolaryngology Head and Neck Surgery, Fuxing Hospital, Capital Medical University, Beijing, China.

出版信息

Am J Audiol. 2019 Mar 15;28(1):95-100. doi: 10.1044/2018_AJA-18-0095.

Abstract

Purpose Idiopathic sudden sensorineural hearing loss is a clinical emergency with an increased incidence of occurrence in recent years. Hyperbaric oxygen has been widely used in the clinical treatment of sudden hearing loss. However, prognostic factors related to its curative effects are still not clear, which hinders its clinical application. The aim of this study was to investigate the efficacy and prognostic factors of hyperbaric oxygen therapy (HBOT) plus drug therapies in the treatment of sudden hearing loss. Method Patients with sudden hearing loss who were treated with hyperbaric oxygen from April to October 2017 were retrospectively included. Clinical information was collected, including pure-tone audiometry data before and after hyperbaric oxygen treatment, age, gender, hearing curve classification, concomitant symptoms, history of diseases (diabetes and hypertension), history of hormone therapy, start time of hyperbaric oxygen treatment, and total number of hyperbaric oxygen treatments. The prognostic factors were analyzed with univariate and multivariate analyses. Results Sixty-four patients with sudden hearing loss were enrolled, including 7 cases of low-frequency loss, 4 cases of high-frequency loss, 32 cases of flat loss, and 21 cases of complete hearing loss. After HBOT, there were 16 cases (25%) of complete recovery, 15 cases (23.43%) of partial recovery, 7 cases (10.93%) of slight improvement, and 26 cases (40.63%) of no improvement. The total effective rate was 59.37%. Twelve of 21 cases (57.14%) of complete hearing loss showed recovery. Multivariate logistic regression analysis showed that the start time of HBOT ≤ 7 days from disease onset was independently associated with hearing recovery ( OR = 27.763, 95% CI [4.209, 183.115], p = .001). Conclusion Combined HBOT can improve the hearing impairment of sudden hearing loss. The early HBOT showed the most promising therapeutic effects, especially among patients with complete hearing loss.

摘要

目的 特发性突发性感音神经性听力损失是一种临床急症,近年来发病率呈上升趋势。高压氧已广泛应用于突发性听力损失的临床治疗。然而,与其疗效相关的预后因素仍不明确,这阻碍了其临床应用。本研究旨在探讨高压氧治疗(HBOT)联合药物治疗突发性听力损失的疗效及预后因素。方法 回顾性纳入2017年4月至10月接受高压氧治疗的突发性听力损失患者。收集临床资料,包括高压氧治疗前后的纯音听力测定数据、年龄、性别、听力曲线分类、伴随症状、疾病史(糖尿病和高血压)、激素治疗史、高压氧治疗开始时间以及高压氧治疗总次数。采用单因素和多因素分析对预后因素进行分析。结果 纳入64例突发性听力损失患者,其中低频损失7例,高频损失4例,平坦型损失32例,全聋21例。HBOT治疗后,完全恢复16例(25%),部分恢复15例(23.43%),轻度改善7例(10.93%),无改善26例(40.63%)。总有效率为59.37%。21例全聋患者中有12例(57.14%)听力恢复。多因素logistic回归分析显示,发病后≤7天开始HBOT与听力恢复独立相关(OR = 27.763,95%CI[4.209,183.115],p = 0.001)。结论 联合HBOT可改善突发性听力损失的听力障碍。早期HBOT显示出最有前景的治疗效果,尤其是在全聋患者中。

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