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中耳腔注射与耳后注射治疗糖尿病患者突发性聋的疗效比较。

Efficacy of Mesotympanum Injection and Posterior Auricular Injection in Sudden Hearing Loss of Diabetes Patients.

机构信息

E.N.T Department, Beichen Hospital, Tianjin, 300400 Tianjin, China.

出版信息

Biomed Res Int. 2022 Jul 19;2022:8494868. doi: 10.1155/2022/8494868. eCollection 2022.

Abstract

The efficacy of tympanum injection and posterior auricular injection in diabetes with sudden hearing loss (SHL) was analyzed. A mobile terminal-based portable pure tone audiometry system and its processing method were established. Based on mobile terminals, a portable pure tone audiometry system including an Android system, pure sound signal generation, pure tone hearing threshold, and client module was established. A masking model and self-adaptive algorithm were used to detect and reduce noise. Besides, the performance of the portable pure tone audiometry system was detected. A total of 46 diabetes patients with SHL diagnosed at the otolaryngology department in BeiChen Hospital between August 2019 and November 2021 were selected as the research objects and randomly divided into the retroauricular group (posterior auricular injection) and the tympanic group (tympanum injection). Each group included 23 cases. All patients received pure tone audiometry (PTA) before and after the treatment. The changes in fasting blood glucose (FPG), 2h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA1c) of the patients were monitored before and after the treatment. Besides, tinnitus loudness visual analog scale (VAS), pain VAS, efficacy, and the incidence of adverse reactions of the patients in two groups were compared. The results indicated that the hear threshold error detected by the medical audiometer and a portable pure tone audiometry system was within 2dB. Before the optimization, there was an error of about 10dB between the hear thresholds detected by the self-adaptive algorithm and a medical audiometer. After the treatment, the hear threshold and average PTA of the patients in the retroauricular and the tympanic groups under different frequencies were both reduced compared with those before the treatment ( < 0.05). The tinnitus VAS score in the retroauricular group was decreased more notably than that in tympanic group ( < 0.01), and the pain VAS score was much lower than that in the tympanic group ( < 0.001). The comparison of FPG, 2hPG, HbA1c, the proportions of cured, significantly effective, effective, ineffective patients, and the total effective rate in the patients in the retroauricular and the tympanic groups before and after the treatment all showed no statistical differences ( > 0.05). The incidence of adverse reactions in tympanic group after the treatment was dramatically higher than that in retroauricular group ( < 0.001). The above results demonstrated that posterior auricular injection showed potential application values in the treatment of SHL with diabetes and established a portable pure tone audiometry system as well as its noise processing method.

摘要

分析了鼓室注射和耳后注射对糖尿病伴突发性聋(SHL)的疗效。建立了一种基于移动终端的便携式纯音测听系统及其处理方法。基于移动终端,建立了包括 Android 系统、纯音信号产生、纯音听阈和客户端模块的便携式纯音测听系统。采用掩蔽模型和自适应算法检测和降低噪声。此外,还检测了便携式纯音测听系统的性能。选取 2019 年 8 月至 2021 年 11 月在北宸医院耳鼻喉科诊断为糖尿病伴突发性聋的 46 例患者为研究对象,随机分为耳后组(耳后注射)和鼓室组(鼓室注射),每组 23 例。所有患者在治疗前后均进行纯音测听(PTA)。监测患者治疗前后空腹血糖(FPG)、餐后 2 小时血糖(2hPG)和糖化血红蛋白(HbA1c)的变化。比较两组患者的耳鸣响度视觉模拟量表(VAS)、疼痛 VAS、疗效及不良反应发生率。结果表明,医用听力计和便携式纯音听力计检测的听阈误差在 2dB 以内。优化前,自适应算法检测的听阈与医用听力计相差约 10dB。治疗后,耳后组和鼓室组在不同频率下的听阈和平均 PTA均低于治疗前(<0.05)。耳后组耳鸣 VAS 评分下降较鼓室组更明显(<0.01),疼痛 VAS 评分明显低于鼓室组(<0.001)。治疗前后耳后组和鼓室组患者 FPG、2hPG、HbA1c、痊愈、显效、有效、无效患者比例及总有效率比较,差异均无统计学意义(>0.05)。治疗后鼓室组不良反应发生率明显高于耳后组(<0.001)。上述结果表明,耳后注射对糖尿病伴突发性聋有潜在的应用价值,建立了便携式纯音测听系统及其噪声处理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd32/9325636/2219d7c0a464/BMRI2022-8494868.001.jpg

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