突发性耳聋预后相关因素的回顾性研究

发布时间：2018-05-19 20:18

本文选题：突发性耳聋 + 回顾性　；参考：《广州中医药大学》2010年硕士论文

【摘要】： 背景突发性耳聋又称特发性突聋,目前突发性耳聋的确切病因不明,一般认为其原因主要有病毒感染、内耳微循环障碍、代谢障碍、免疫因素、内耳蜗窗破裂等,另有报道与心理因素相关。1944年首先描述此病,近年来发病率有逐渐升高的趋势,由于对发病机理的认识不明确,目前对于突发性耳聋的治疗尚无确切有效的治疗方法。目的本课题采用回顾性研究方法,通过文献研究,选取多项与突发性耳聋预后可能相关的因素进行统计分析,从而探讨它们对于突发性耳聋的预后及转归是否存在影响,为突发性耳聋的治疗及判断提高一定的依据。方法根据纳入及排除标准,选择2006年1月至2009年12月在广东省中医院耳鼻喉科住院,第一诊断为突发性耳聋病例共320例(341耳)作为研究对象,通过文献研究,选取多项与突发性耳聋预后可能相关的因素,如性别、年龄、患耳侧别、发病至就诊时间、伴发症状、基础疾病、听力损失程度、听力损失曲线类型、发病季节、住院时间以及治疗方式等进行统计分析,所得数据单因素采用卡方检验,分别比较各组治疗有效率的差异；再用Logistic多元回归分析总体评价各相关因素对预后的影响。结果本研究共纳入320例患者(341耳),其中男性163例,女性157例,平均年龄46.68±16.94岁,平均住院时间为12.03±5.16天,其中伴高血压者53例,伴有颈椎病者19例,伴糖尿病16例,伴心脏病14例。伴有眩晕者58例,伴有耳鸣者299例,春季发病84例,夏季发病67例,秋季发病89例,冬季发病80例。单因素分析结果,治疗后总有效率为65.63%,其中患者性别、患耳侧别、发病季节、住院时间、有无伴耳鸣、有无高血压病史、糖尿病史、颈椎病史与预后无明显相关性(P0.05)。患者年龄、发病至就诊时间、听力损失程度、听力损失曲线类型、是否伴发眩晕、使用不同药物治疗等因素与预后有关(P0.05)。多因素的1ogistic回归分析中,仅年龄、发病至就诊治疗时间、听力损失程度、听力损失曲线类型及不同药物治疗等因素与预后有相关性(P0.05)。结论 1.发病后早期就诊,对突发性耳聋的恢复有很大帮助,越早治疗效果越好,病程超过1月,治疗效果显著下降；2.听力损失程度越小,恢复的可能性越大；3.低频下降的听力损失(上升型)预后要好于其他曲线类型；4.青壮年患者预后好于老年人。5.通过Logistic回归分析,患者伴发眩晕这个因素被剔除。患者性别、患耳侧别、发病季节、住院时间、有无伴眩晕、耳鸣、有无高血压病史、糖尿病史、颈椎病史与预后无明显相关性(P0.05)；患者年龄、发病至就诊时间、听力损失程度、听力损失曲线类型及不同药物治疗等因素与预后有关(P0.05)。
[Abstract]:Background Sudden deafness is also called idiopathic sudden deafness. At present, the exact etiology of sudden deafness is unknown. It is generally believed that the main causes of sudden deafness are virus infection, inner ear microcirculation disorder, metabolic disorder, immune factors, rupture of inner cochlear window, etc. Other reports were related to psychological factors. The disease was first described in 1944. The incidence of the disease has been increasing in recent years. Due to the lack of clear understanding of the pathogenesis, there is no effective treatment for sudden deafness at present. Purpose In this paper, a retrospective study method was used to analyze several factors related to the prognosis of sudden deafness by literature study, so as to find out whether they have an effect on the prognosis and outcome of sudden deafness. To improve the treatment and judgment of sudden deafness. Method According to the criteria of inclusion and exclusion, 320 cases (341 ears) of sudden deafness were selected from January 2006 to December 2009 in Department of Otorhinolaryngology, Guangdong Provincial Hospital of traditional Chinese Medicine. Several factors related to prognosis of sudden deafness were selected, such as sex, age, ear type, time from onset to visit, accompanied symptoms, basic diseases, degree of hearing loss, type of hearing loss curve, season of onset. The hospital stay and treatment methods were statistically analyzed, the data were analyzed by chi-square test, the difference of the effective rate of treatment was compared, and the influence of the related factors on the prognosis was evaluated by Logistic multivariate regression analysis. Result A total of 320 patients were enrolled in this study, including 163 males and 157 females, with an average age of 46.68 卤16.94 years and an average hospital stay of 12.03 卤5.16 days. 53 patients were associated with hypertension, 19 patients with cervical spondylosis, 16 patients with diabetes mellitus and 14 patients with heart disease. There were 58 cases with vertigo, 299 cases with tinnitus, 84 cases in spring, 67 cases in summer, 89 cases in autumn and 80 cases in winter. Univariate analysis showed that the total effective rate after treatment was 65.63. There was no significant correlation between the patient's sex, ear type, onset season, hospitalization time, tinnitus, hypertension, diabetes, cervical spondylosis and prognosis. Age, time from onset to visit, degree of hearing loss, type of hearing loss curve, whether accompanied by vertigo, different drug therapy and other factors were related to prognosis (P 0.05). In multivariate 1ogistic regression analysis, only age, time from onset to treatment, degree of hearing loss, type of hearing loss curve and different drug therapy were correlated with prognosis (P 0.05). Conclusion 1. The early visit after onset of deafness is of great help to the recovery of sudden deafness. The earlier the treatment is, the better. The course of disease is more than one month, and the therapeutic effect is significantly decreased by 2. 5%. The smaller the degree of hearing loss, the more likely it is to recover. The prognosis of hearing loss (ascending type) with low frequency decrease was better than that of other curve types. The prognosis of the young and adult patients is better than that of the elderly. By Logistic regression analysis, the patient with vertigo was excluded. There was no significant correlation between the patient's sex, ear side, onset season, hospitalization time, vertigo, tinnitus, history of hypertension, diabetes, cervical spondylosis and prognosis (P 0.05). The type of hearing loss curve and different drug therapy were related to prognosis (P 0.05).
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R764

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