妊娠期突发性感觉神经性聋：病因、治疗和结局。
Sudden sensorineural hearing loss during pregnancy: etiology, treatment, and outcome.
机构信息
Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing City, China.
出版信息
J Int Med Res. 2021 Feb;49(2):300060521990983. doi: 10.1177/0300060521990983.
OBJECTIVE
To analyze the etiologies, treatments, and outcomes of sensorineural hearing loss (SSNHL) during pregnancy.
STUDY DESIGN
Retrospective chart review of 25 pregnant patients treated for SSNHL between January 2012 and September 2019. Forty-nine age matched non-pregnant women with severe and profound hearing loss diagnosed with SSNHL during the same period served as controls. Data were recorded on age, symptoms, onset of hearing loss, audiometric results, treatments, and outcomes.
RESULTS
The mean age was 29.6 years (range 23-38 years). Intratympanic steroids (ITS) were administered in 15 (60.0%) pregnant women with SSNHL. Three women were treated with postauricular steroids only, while another woman was treated with intravenous ginkgo leaf extract and dipyridamole. The remaining six women received no medications. More than half (8/15, 53.3%) of pregnant women with SSNHL receiving ITS experienced hearing improvement. Pregnant women with profound hearing loss who received no medication had no hearing improvement. Most pregnant women with SSNHL (12/15, 80.0%) had higher fibrinogen levels than controls (mean values 3.77±0.71 g/L and 2.54±0.48 g/L, respectively).
CONCLUSION
Fibrinogen could be a risk factor for SSNHL during pregnancy. ITS may benefit pregnant women with severe and profound SSNHL.
目的
分析妊娠期感音神经性听力损失（SSNHL）的病因、治疗方法和转归。
研究设计
回顾性分析了 2012 年 1 月至 2019 年 9 月期间 25 例因 SSNHL 接受治疗的孕妇病例。同期选取 49 名年龄匹配的非妊娠、患有严重和极重度 SSNHL 的女性作为对照组。记录了患者的年龄、症状、听力损失起始时间、听力测试结果、治疗方法和转归等数据。
结果
患者的平均年龄为 29.6 岁（23-38 岁）。15 例（60.0%）SSNHL 孕妇接受了鼓室内皮质类固醇（ITS）治疗。3 例仅接受了耳后皮质类固醇治疗，另 1 例接受了银杏叶提取物和双嘧达莫静脉注射治疗，其余 6 例未接受任何药物治疗。接受 ITS 治疗的 8 例（53.3%）SSNHL 孕妇中超过一半听力得到改善。未接受药物治疗的 10 例极重度 SSNHL 孕妇听力无改善。大多数 SSNHL 孕妇（12/15，80.0%）的纤维蛋白原水平高于对照组（均值分别为 3.77±0.71g/L 和 2.54±0.48g/L）。
结论
纤维蛋白原可能是妊娠期 SSNHL 的危险因素。ITS 可能有益于治疗严重和极重度 SSNHL 孕妇。
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