听神经病谱系障碍患者的内科药物综合治疗及疗效分析

发布时间：2018-06-28 06:03

本文选题：听神经病谱系障碍 + 前庭耳蜗神经疾病　；参考：《临床耳鼻咽喉头颈外科杂志》2014年08期

【摘要】：目的:分析听神经病谱系障碍患者经内科药物综合治疗的临床疗效以及相关因素对预后的影响。方法:对11例(22耳)经纯音测听、声导抗、畸变产物耳声发射、听性脑干反应测试确诊为听神经病谱系障碍者(治疗组)予以内科药物综合治疗,同时选取同期就诊但未接受治疗的11例听神经病谱系障碍患者作为对照组,分析比较治疗组治疗前后和对照组患者随诊前后的纯音听阈和言语识别率变化,并分析患者的性别、年龄和伴随症状与疗效的关系。统计数据应用SPSS 19.0行配对样本t检验、独立样本t检验和Pearson相关分析。结果:经内科药物综合治疗后,治疗组22耳中,治疗有效13耳,有效率为59.09%。治疗组22耳平均纯音听阈由治疗前的(53.92±18.86)dB HL提升至(47.44±14.98)dB HL,差异有统计学意义(t=5.20,P0.05);而对照组听力无明显变化(P0.05)。治疗组言语识别率治疗前后分别为(29.20±25.80)%和(41.60±22.90)%,平均提高(12.40±13.80)%,差异有统计学意义(t=4.02,P0.05)。伴有耳鸣症状者疗效较无耳鸣症状者差(t=-3.85,P0.05),发病年龄和疗效呈负相关(r=-6.72,P0.05),而疗效未见性别差异(P0.05)。结论:听神经病谱系障碍患者应用糖皮质激素等内科药物综合治疗可有效改善其纯音听阈和言语识别率,内科药物综合治疗可作为听神经病谱系障碍治疗的可选方案。
[Abstract]:Objective: to analyze the clinical effect of comprehensive medical therapy in patients with auditory neuropathy spectrum disorders and the influence of related factors on prognosis. Methods: 11 patients (22 ears) diagnosed by pure tone audiometry, acoustic impedance, distortion product otoacoustic emission and auditory brainstem response test were treated with medical drugs. At the same time, 11 patients with auditory neuropathy spectrum disorders were selected as control group. The changes of pure tone hearing threshold and speech recognition rate before and after treatment and follow-up were compared, and the sex of the patients were analyzed. Relationship between age and associated symptoms and efficacy. SPSS 19.0 matched sample t test, independent sample t test and Pearson correlation analysis were used. Results: in the treatment group, 13 ears were effective and the effective rate was 59.09. The mean pure tone hearing threshold of 22 ears in the treatment group increased from (53.92 卤18.86) dB HL to (47.44 卤14.98) dB HL in the treatment group (t = 5.20 P 0.05), but there was no significant change in the hearing in the control group (P 0.05). The speech recognition rate before and after treatment was (29.20 卤25.80)% and (41.60 卤22.90), with an average increase of (12.40 卤13.80) (P 0.05). The effect of tinnitus in patients with tinnitus was worse than that without tinnitus (t = 3.85). The age of onset was negatively correlated with the efficacy (r = 6.72P 0.05), but there was no gender difference in curative effect (P0.05). Conclusion: the comprehensive therapy of glucocorticoid and other medical drugs can effectively improve the pure tone hearing threshold and speech recognition rate in patients with auditory neuropathy spectrum disorders.
【作者单位】：解放军总医院耳鼻咽喉头颈外科;
【基金】：国家重大科学研究计划项目(No:2014CB943001) 国家自然基金重大国际合作项目(No:81120108009) 全军“十二五”重点项目(No:BWS11J026)
【分类号】：R764.4

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