妊娠期突发性感音神经性聋21例报道

发布时间：2019-07-18 10:04

【摘要】：目的分析妊娠期突发性聋临床表现特点,探讨安全有效的治疗措施。方法分析2005年6月到2013年12月间21例妊娠期突发性聋的临床表现特点及诊疗经过、疗效。突发性聋的诊断及疗效评估参照2005年济南会议的标准,治疗过程中观察纯音听力恢复情况。治疗方案:发病3天以内中度以下低中频型聋2例,首选门诊随诊观察,其余19例选择药物治疗:①低分子右旋糖酐-40500ml静脉点滴每天1次,14天为1疗程,听力恢复则随时停药;同时口服强的松,按照1mg/kg体重开始,每日总量不超过60mg,其后每3天减少10mg;如低分子右旋糖酐-40皮试过敏,改备用方案:②葛根素注射液250ml静脉点滴及口服强的松,疗程同方案①。治疗过程由产科医生负责超声监测胎儿是否存在畸形、宫内发育迟缓、低体重。对经治病例进行半年以上的母婴健康状况随访,内容为母亲听力及肝肾功能、儿童的生长发育、智力及听力言语情况。结果治疗前纯音听力曲线包括低中频下降型6例(6耳)、平坦型7例(7耳)、全聋5例(5耳)、覆盆型1例(1耳)、峰型1例(双耳),槽型1例(1耳)。痊愈13例,显效3例,有效2例,无效3例。随访0.5~5年,母婴健康。结论妊娠期间突发性聋的治疗需谨遵孕妇用药原则,低分子右旋糖酐、葛根素及强的松治疗妊娠期间突发性耳聋的疗效显著,在治疗及随访期内未发现明显不良反应,中度以下低中频型聋有自愈倾向,发病3天以内的患者可首选门诊随诊观察。
[Abstract]:Objective To analyze the clinical features of sudden deafness in pregnancy and to explore the safe and effective treatment measures. Methods The clinical features and curative effect of 21 cases of sudden deafness during the period from June 2005 to December 2013 were analyzed. The diagnosis and curative effect evaluation of sudden deafness refers to the standard of Jinan conference in 2005, and the hearing recovery of pure tone is observed in the course of treatment. The treatment scheme:2 cases with low intermediate-frequency-type deafness with moderate or lower middle-frequency-type deafness within 3 days of the attack, and the first preferred out-patient follow-up observation. The remaining 19 cases were treated with the following drugs:1 time per day for low-molecular-low-molecular dexterotonin-40500ml intravenous drip,1 course of treatment for 14 days, and the hearing recovery was stopped at any time; and the oral prednisone was also taken orally. At the beginning of 1 mg/ kg body weight, the total daily amount was not more than 60 mg, followed by a decrease of 10 mg every 3 days; for example, the low-molecular right-rotation sugar-40 skin test had an allergic reaction, and the alternative was changed: the injection of puerarin injection 250ml intravenous drip and oral prednisone, and the course of treatment was the same as that of the protocol. In the course of treatment, the obstetrician is responsible for the ultrasonic monitoring of the presence of malformations, intrauterine growth retardation, and low body weight. The follow-up of mother-to-child health status for more than half a year of the treated case is the mother's hearing and the function of the liver and the kidney, the development of the child, the intelligence and the hearing. Results The pre-treatment pure tone hearing curve consisted of 6 (6 ears),7 (7 ears),5 (5 ears),1 (1 ears),1 (2 ears) and 1 (1 ears) of the low IF descending type,7 (7 ears),5 (5 ears),1 (1 ears),1 (2 ears) and 1 (1 ears). 13 cases were cured,3 cases were markedly effective,2 cases were effective, and 3 cases were ineffective. The follow-up period was 0.5 to 5 years, and the mother-to-child health was Conclusion The treatment of sudden deafness during pregnancy should be in accordance with the principle of the use of pregnant women, the obvious curative effect of low-molecular, right-rotation, puerarin and prednisone in the treatment of sudden deafness during pregnancy, no obvious adverse reaction is found during the treatment and follow-up period, and the low-intermediate-frequency-type deafness with moderate or lower middle-frequency type has self-healing tendency. The patients within 3 days of the onset of the disease may be selected for outpatient visit.
【作者单位】：中山大学附属三院耳鼻咽喉头颈外科;江西省武宁县人民医院;
【基金】：广州市科技计划项目2013KP089
【分类号】：R764.431

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