191例主观性耳鸣的临床治疗体会

发布时间：2018-01-29 20:29

本文关键词： 主观性耳鸣掩蔽疗效相关因素　出处：《郑州大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的：探讨主观性耳鸣的治疗及影响疗效与预后的相关因素。方法：对2010年7月至2011年2月就诊于郑州大学第一附属医院耳科门诊的以耳鸣为第一主诉的患者,行客观检测包括纯音测听、声导抗、耳声发射、耳鸣检测(耳鸣响度和频率匹配、耳鸣掩蔽曲线、残余抑制试验),筛选出确诊为主观性耳鸣且残余抑制试验阳性的患者191例。治疗前询问病史,给予病情分级。使用改善微循环等药物,同时辅以掩蔽治疗,每天三次,每次30分钟,并随着患者病情变化调整掩蔽声频率和强度,每个疗程15天,坚持至少两个疗程。结果：据本资料统计,191例患者中2级耳鸣33例,3级耳鸣83例,4级耳鸣55例,5级耳鸣12例,6级耳鸣8例。病程1天-15年；短于3月的68例,3月至15年的123例；有噪声接触史的23例；伴有三高(高血压、高血糖、高血脂)的53例,听力正常的49例,轻度听力损失者65例,中度听力损失者64例,重度听力损失者13例。经治疗后痊愈16例,显效27例,有效57例,无效91例,总有效率52.6%。将病人按照病程、有无三高,有无噪声接触史以及听力损失程度分组,计算有效率,并进行统计学分析,主观性耳鸣的疗效与病程、有无三高、有无噪声接触史显著相关；其疗效与听力损失程度关系无统计学意义。结论：耳鸣预后与耳鸣发病时间的长短、是否伴有三高、是否有噪声接触史等有关,与听力损失程度关系不大。发病时间长、伴有三高、有噪声接触史的患者疗效不理想。患者发病应及时就诊,伴有三高的患者需在治疗耳鸣的同时进行规范的控制血压血脂及血糖的治疗,患者应有健康的心理状态,相信耳鸣可以治愈。
[Abstract]:Objective: Objective: to explore the treatment of subjective tinnitus and the related factors affecting curative effect and prognosis. Methods: From July 2010 to February 2011, we examined the patients with tinnitus as the first complaint, including pure tone audiometry, acoustic conductance, and otoacoustic emission in the otological clinic of the first affiliated Hospital of Zhengzhou University. Tinnitus test (tinnitus loudness and frequency matching, tinnitus masking curve, residual inhibition test), 191 patients with subjective tinnitus and positive residual inhibition test were selected. The patients were given disease grade. The patients were treated with drugs such as improving microcirculation and masking for 30 minutes three times a day. The frequency and intensity of masking sound were adjusted for 15 days with the change of the patient's condition. Maintain at least two courses of treatment. Results: According to the data, 33 cases of grade 2 tinnitus, 83 cases of grade 3 tinnitus, 55 cases of grade 4 tinnitus, 55 cases of grade 5 tinnitus, 12 cases of grade 6 tinnitus, 8 cases of grade 6 tinnitus, the course of disease was from 1 day to 15 years. It was shorter than 68 cases on March and 123 cases from March to 15 years. 23 cases had a history of noise exposure; There were 53 cases with high blood pressure, hyperglycemia and hyperlipidemia, 49 cases with normal hearing, 65 cases with mild hearing loss and 64 cases with moderate hearing loss. After treatment, 16 cases were cured, 27 cases were effective, 57 cases were effective, 91 cases were ineffective, and the total effective rate was 52.6%. Whether there was any history of exposure to noise and the degree of hearing loss were divided into groups, the effective rate was calculated, and statistical analysis was made. The curative effect of subjective tinnitus was significantly correlated with the course of disease, whether there were three high levels or not, and whether there was any history of noise exposure. There was no significant relationship between the curative effect and the degree of hearing loss. Conclusion: The prognosis of tinnitus is related to the duration of tinnitus onset, whether there are three high, whether there is a history of noise exposure, and so on, but not related to the degree of hearing loss. Patients with noise-exposed history of treatment should be timely treatment, accompanied by three high patients should be in the treatment of tinnitus at the same time standardized control of blood pressure, blood lipid and blood sugar treatment. Patients should have a healthy psychological state, I believe tinnitus can be cured.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764

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