少年儿童突发性聋的治疗及预后分析

发布时间：2018-06-03 02:40

本文选题：少年儿童 + 突发性耳聋　；参考：《中华耳科学杂志》2017年05期

【摘要】：目的探讨少年儿童突发性聋临床特点、治疗及预后因素分析。方法回顾性分析2011年1月至2016年12月间我科收治的78例(81耳)儿童突发性聋的病例资料。共收集病例78例,81耳,双耳3例,其中男性40例(51.28%),女性38例(48.72%)。年龄9-18岁,平均年龄15.69岁。按照听力曲线分型,低频下降型27例,中高频下降型9例,平坦型17例,全聋型25例。分析不同类型突发性聋患儿的临床特点及治疗效果,运用logistic回归分析其预后因素。Fisher检验比较不同类型突发性聋患儿是否采用特殊治疗(鼓室/耳后注射激素)对预后的影响。结果各种类型的总有效率:低频下降型最高,为96.30%;其次为平坦型,全聋型次之,分别为76.47%,52.00%;中高频型最差,为44.44%。所有患儿总有效率为71.79%。无耳鸣患儿14例,总有效率为50%;伴耳鸣患儿64例,总有效率为76.56%。4例患儿耳后注射复方倍他米松,1例有效;21例患者采用鼓室注射甲强龙,14例有效;3例患者采用联合鼓室注射甲强龙和耳后注射复方倍他米松,1例有效。多因素Logistic回归分析结果显示,突发性聋分型、是否伴发耳鸣与少年儿童突发性聋治疗效果相关。结论低频型、伴发耳鸣的少年儿童突发性聋患者预后好,中高频型、无耳鸣的患儿预后较差。耳后注射及鼓室注射激素对首次治疗无效的患儿仍然有效。
[Abstract]:Objective to investigate the clinical features, treatment and prognostic factors of sudden deafness in children. Methods the data of 78 children with sudden deafness from January 2011 to December 2016 were retrospectively analyzed. A total of 78 cases (81 ears) and 3 ears (40 males) and 38 females (48.72%) were collected. The average age was 15.69 years. According to the classification of hearing curve, there were 27 cases of low frequency type, 9 cases of middle and high frequency type, 17 cases of flat type and 25 cases of total deafness type. The clinical characteristics and therapeutic effects of different types of sudden deafness were analyzed. The prognostic factors of different types of sudden deafness were analyzed by logistic regression analysis. Fisher test was used to compare the effect of special treatment (hormone injection) on the prognosis of children with different types of sudden deafness. Results the total effective rate of each type was the highest (96.30) in the low frequency type, followed by the flat type, followed by the total deafness type (76.4752.00) and the middle and high frequency type (44.4444). The total effective rate of all children was 71.79. There were 14 cases without tinnitus and 64 cases with tinnitus. The total effective rate was 76.56.4 children with retroauricular injection of compound betamethasone. One case with effective betamethasone was treated with intratympanic injection of methylenolone in 14 cases and 3 cases with effective treatment with intraauricular injection of metoprolol and retroauricular injection of compound betamethasone in 1 case. Multivariate Logistic regression analysis showed that the classification of sudden deafness and tinnitus were related to the treatment effect of sudden deafness in children. Conclusion the prognosis of children with sudden deafness with low frequency and tinnitus is better than that without tinnitus. Retroauricular injection and tympanic injection of hormones are still effective in children who have not been treated for the first time.
【作者单位】：重庆医科大学附属第一医院耳鼻咽喉科;
【分类号】：R764.437

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