The efficacy of hyperbaric oxygen in the treatment of sudden sensorineural hearing loss
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摘要: 目的 探讨高压氧治疗突发性聋(SSNHL)的不同方案的疗效差异。方法 选取107例SSNHL患者，按照随机数字表法分为3组：A组38例给予高压氧治疗1次/d，治疗10 d后休息1 d，共连续给予高压氧治疗20次; B组27例给予高压氧治疗2次/d，共10 d; C组42例不给予高压氧治疗。按照SSNHL诊断和治疗指南(2015)的建议均给予患者常规药物治疗14 d。A组治疗结束后即复查纯音测听，B、C两组患者均在治疗20 d后复查纯音测听。结果 A组总体有效率为78.9%，听阈提高值为(27.2±17.5) dB HL; B组总体有效率为81.5%，听阈提高值为(26.9±16.7) dB HL; C组总体有效率为61.9%，听阈提高值为(17.6±18.5) dB HL。C组与A、B组疗效比较差异均有统计学意义，而A组与B组疗效比较差异无统计学意义。结论 高压氧联合药物治疗SSNHL的近期疗效优于单纯药物治疗，临床上可根据患者自身情况选取不同的高压氧联合药物治疗方案。Abstract: Objective To investigate the therapeutic effect of hyperbaric oxygen on sudden sensorineural hearing loss(SSNHL).Method One hundred and seven patients with SSNHL were selected, and were randomly divided into 3 groups according to admission order. Therapeutic schedule in group A (38 cases) consisted of hyperbaric oxygen treatment once a day for 10 consecutive days, then 1 day off treatment, and on treatment for another 10 consecutive days (20 treatments in total). Twenty-seven patients in group B were treated with hyperbaric oxygen twice per day for a total of 10 days. Forty-two patients in group C didn't receive hyperbaric oxygen therapy. Meanwhile, all patients were given conventional treatment for 14 days in accordance with the recommendations of the otolaryngology, head and neck branch of the Chinese medical association for the diagnosis and treatment of sudden sensorineural hearing loss. Patients in group A underwent pure tone audiometry after the end of treatment, and patients in group B and C were reexamined 20 days after the start of treatment, and the treatment efficacy of the three groups was compared.Result The overall effective rate of group A was 78.9%, and the improvement of hearing threshold was(27.2±17.5) dB HL. In group B, the overall effective rate was 81.5%, and the improvement of threshold value was(26.9±16.7) dB HL. The overall effective rate of group C was 61.9%, and the improvement of threshold value o was(17.6±18.5) dB HL. The effective rate of group C was significantly higher than that of group A or B, while there was no significant difference in efficacy between group A and group B.Conclusion The efficacy of hyperbaric oxygen combined with drug therapy for SSNHL is better than that of drug therapy alone. Programs of different hyperbaric oxygen combined with drug therapy can be selected on an individual basis.
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表 1 3组患者临床资料比较
x±s 组别 年龄/岁 性别 病程/d 听力曲线类型 治疗前听阈/dB HL 男 女 低频型 高频型 平坦全聋型 A组 40.3±13.6 17 21 6.2±4.1 8 6 24 64.4±13.8 B组 42.7±16.3 13 14 6.5±3.2 5 5 17 62.8±16.6 C组 40.6±15.2 19 23 5.8±4.3 10 9 23 66.5±18.1 
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表 2 3组患者的疗效比较
例(%) 组别 例数 痊愈 显效 有效 无效 总有效 治疗后听阈/dB HL 听阈提高值/dB HL A组 38 9(23.7) 10(26.3) 11(28.9) 8(21.1) 30(78.9)1) 31.1±20.5 27.2±17.51) B组 27 6(22.2) 6(22.2) 10(37.0) 5(18.5) 22(81.5)1) 29.5±23.7 26.9±16.71) C组 42 6(14.3) 7(16.7) 13(30.9) 16(38.1) 26(61.9) 39.3±24.7 17.6±18.5 与C组比较，1)P < 0.05。
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