-
摘要: 目的: 分析儿童突发性聋患者的疗效及影响突发性聋预后的相关因素,以指导临床诊断和治疗。方法: 本文选取2010-11-2015-05期间在解放军总医院耳内科住院治疗的0~18岁有较完整临床资料的101例(113耳)儿童突发性聋患者的资料,对其治疗效果进行回顾性研究,分析儿童突发性聋患者的性别、初诊时间、听力损失程度、是否伴发眩晕、耳鸣等相关因素对预后的影响。结果: 101例(113耳)儿童突发性聋患者中,男60耳,女53耳;单耳发病89耳,双耳发病24耳;发病至就诊时间1~183 d,平均(18.5±22.1)d。8耳(7.1%)为轻度听力损失,7耳(6.2%)为中度听力损失,27耳(23.9%)为重度听力损失,71耳(62.8%)为极重度听力损失。伴发耳鸣症状者88耳(77.9%),伴发眩晕症状者62耳(54.9%)。经系统治疗后痊愈11耳(9.7%),总有效率为36.3%。对儿童突发性聋的相关因素进行统计学分析,其中听力损失程度,初诊时间,性别,侧别对疗效的影响有统计学意义(P<0.05)。结论: 儿童突发性聋患儿一般听力损失重;但经积极及时的治疗后,仍有好转甚至痊愈的可能。初诊时间越短、听力损失程度越轻者疗效较好;单侧聋患者较双侧聋患者疗效好;女性患者较男性患者疗效好。是否伴发耳鸣、眩晕,ABR及DPOAE是否引出对儿童突发性聋的预后无明显的影响。Abstract: Objective: The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children, and explore the prognostic factors in order to guide the clinical diagnosis and treatment.Method: A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5 years(from November 2010 to May 2015) in Chinese PLA General Hospital.This paper have a complete clinical data of 101 patients (113 ears)with sudden hearing loss, ranging from 0 to 18 years old. Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed.Result: Among 101 patients(113 ears),the ratio of male and female was 60:53. Treatment was initiated from 1 to 183 days after disease onset, with an average of (18.5±22.1)d. Bilateral and unilateral hearing loss were 24 ears and 89 ears, respectively. The proportion of mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss were 7.1%, 6.2%, 23.9% and 62.8%, respectively. Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients, respectively.After the treatment, the complete recovery rate was 9.7% and the overall recovery rate was 36.3%. The degree of hearing loss, earlier treatment onset, sex and bilateral involvement were significantly associated with hearing recovery (P<0.05).Conclusion: Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss, but after positive and timely treatment, it can be improved or even cured. The mild hearing loss, earlier treatment onset, unilateral hearing loss and female were positive prognostic factors. The concurrence of tinnitus or vertigo, the results of ABR and DPOAE had no significant influence on prognosis.
-
Key words:
- sudden hearing loss /
- children /
- prognostic factors
-
[1] 冀飞,吴子明,王秋菊.儿童突聋与眩晕的诊治--北京市0~6岁儿童听力筛查诊断中心2013年第一季度学术讨论会纪要[J].中华耳科学杂志, 2013,11(1):170-170.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会.突发性聋的诊断和治疗指南(2005年,济南)[J].中华耳鼻咽喉头颈外科杂志, 2006, 41(8):569-569.
[3] 中华医学会耳鼻咽喉科学分会,中华耳鼻咽喉科杂志编委会.突发性聋诊断依据和疗效分级[J].中华耳鼻咽喉杂志,1997,32(2):72-72.
[4] BRAMHALL N F,KALLMAN J C,VERRALL A M,et al.A novel WFSl mutation in a family with dominant low frequency sensorineural hearing loss with normal VEMP and EcochG findings[J].BMC Med Genet,2008,25:48-52.
[5] GARCIA-BERROCAL J R,RAMIREZ-CAMACHO R,LOBO D,et al.Adverse effects of glucocorticoid therapy for inner ear disorders[J].ORL J Otorhinolaryngol Relat Spec,2008,70:271-274.
[6] MAMAK A,YILMAZ S,CANSIZ H,et al.A study of prognosticfactors in sudden hearing loss[J].Ear Nose Throat J,2005,84:641-644.
[7] BATTAGLIA A,BURCHETTE R,CUEVA R.Combination therapy (intratympanic dexamethasone high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearingloss[J].Otol Neurotol,2008,29:453-460.
[8] STACHLER R J, CHANDRASEKHAR S S, ARCHER S M, et al. Clinical practice guideline:sudden hearing loss[J]. Otolaryngol Head Neck Surg, 2012,146:S1-S35.
[9] CHEN Y S,EMMERLING O,ILGNER J,et al.Idiopathic sudden sensorineural hearing loss in children[J].Int J PediatrOtorhinolaryngol,2005,69:817-821.
[10] 王大勇,侯志强,刘岩,等.青少年突发性耳聋的临床特征及疗效分析[J].中华医学杂志, 2013, 93(20):1574-1576.
[11] ROMAN S, ALADIO P, PARIS J, et al. Prognostic factors of sudden hearing loss in children[J]. Int J Pediatr Otorhinol, 2001, 61:17-21.
[12] 王小亚,罗仁忠,陈彦球,等.儿童突发性听力下降的临床特征分析[J].临床耳鼻咽喉头颈外科杂志,2013,27(19):1048-1050.
[13] 徐秀娟,许耀东,刘翔,等.小儿突发性聋临床特征分析[J].听力学及言语疾病杂志,2006,14(6):461-462.
[14] 李红光,彭涛,郭建萍,等.少儿突发性聋36例临床分析[J].川北医学院学报,2008,33(2):149-150.
[15] CHUNG J H, CHO S H, JEONG J H, et al. Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss in children[J]. Laryngoscope,2015,10:25196-25196.
[16] CHO C S,CHOI Y J. Prognostic factors in sudden sensorineural hearing loss:a retrospective study using interaction effects[J]. Braz J Otorhinol, 2013, 79:466-70.
[17] NA S Y, KIM M G, HONG S M, et al. Comparison of sudden deafness in adults and children[J]. Clin Exp Otorhinol, 2014, 7:165-169.
[18] MATTOX D E, SIMMONS FB. Natural history of sudden sensorineural hearing loss[J]. Ann Otol Rhinol Laryngol,1977, 86:463-80.
[19] 海波,程雷.青少年突发性聋的临床特征(附34例报告)[J].临床耳鼻咽喉科杂志,1999,13(10):441-442.
[20] 张萍,李志春,张卫.儿童突聋几个预后相关因素分析[J].中原医刊,2005,32(1):22-23.
[21] 王秋菊,兰兰,韩冰,等.双侧突发性聋患者临床特征与预后分析[J].中华耳科学杂志,2010,8(2):119-128.
[22] 李倩,马晓娟,王大勇,等.突发性聋伴耳鸣患者的临床特征分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(1):57-60.
[23] JECMENICA J, BAJEC-OPANCINA A.Sudden hearing loss in children[J]. Clin Pediatr, 2014, 53:874-878.
[24] 钟润兰,管志伟.儿童突发性聋的临床特征分析[J].齐齐哈尔医学院学报,2011,32(12):1934-1935.
[25] 胡田桂,马未央,蔡东平.少儿突发性聋27例临床分析[J].河北医学, 2005,11(5):463-465.
计量
- 文章访问数: 73
- PDF下载数: 56
- 施引文献: 0