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摘要: 目的 分析儿童突发性耳聋预后的影响因素，为临床预防和治疗提供理论依据。 方法 回顾性分析2016至2023年就诊的109例突发性耳聋患儿的临床资料，按照性别、年龄、患病气候、听力损失时长、伴随症状、听力损失程度、侧别、听力曲线类型8个相关因素进行分组，单因素分析采用χ2检验，并用logistic回归分析影响预后的因素。 结果 经常规治疗后，无效56例(51.4%)，有效30例(27.5%)，显效13例(11.9%)，痊愈10例(9.2%)，总有效率48.6%。伴随症状中伴有单纯耳鸣的患儿治疗效果较好(P＜0.05)；听力损失程度中轻度听力下降的有效率最高(83.3%)，极重度有效率最低(40.0%)；听力曲线类型中低频下降型与中高频下降型预后较好(P＜0.05)；性别，年龄，患病气候，听力损失时长，侧别与预后无明显相关性(P>0.05)。 结论 听力曲线类型与听力损失程度是影响儿童突发性耳聋预后的因素，伴发单纯耳鸣患儿预后较好。Abstract: Objective To analyze the factors influencing the prognosis of sudden sensorineural deafness in children, and to provide theoretical basis for clinical prevention and treatment. Methods The clinical data of 109 children with sudden deafness admitted to our hospital from 2016 to 2023 were retrospectively analyzed. The children were grouped according to eight related factors, including gender, age, climate, duration of hearing loss, concomitant symptoms, degree of hearing loss, sicken ear, and auditory curve. The chi-square test was used for univariate analysis, and logistic regression was employed to identify factors influencing prognosis. Results After conventional treatment, 56 cases were ineffective(51.40%), 30 cases were effective(27.5%), 13 cases were effective(11.9%), 10 cases were cured(9.2%), and the total effective rate was 48.6%. Among concomitant symptoms, children with tinnitus had better treatment results(P < 0.05); In the degree of hearing loss, the effective rate of mild hearing loss was the highest(83.3%), and the effective rate of very severe hearing loss was the lowest(40.0%). The prognosis of low frequency decline and high frequency decline were better(P < 0.05); There was no significant correlation between gender, age, climate, duration of hearing loss, sicken ear and prognosis(P>0.05). Conclusion The auditory curve and the degree of hearing loss are the factors affecting the prognosis of children with sudden deafness. Additionally, children with tinnitus tend to have a better prognosis.
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Key words:
- sudden sensorineural hearing loss /
- children /
- prognosis
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表 1 不同分组突聋患儿疗效单因素分析
例(%) 变量 例数 无效(n=56) 有效(n=53) χ2 P 性别 3.396 0.065 男 58 25(43.1) 33(56.9) 女 51 31(60.8) 20(39.2) 年龄/岁 5.776 0.123 1~5 17 9(52.9) 8(47.1) 6~8 30 20(66.7) 10(33.3) 9~11 36 18(50.0) 18(50.0) 12~15 26 9(34.6) 17(65.4) 气候 0.715 0.398 冷 51 24(47.1) 27(52.9) 热 58 32(55.2) 26(44.8) 听力损失时长/d 3.616 0.306 3 48 20(41.7) 28(58.3) 4~7 39 24(61.5) 15(38.5) 8~14 14 8(57.1) 6(42.9) ≥15 8 4(50.0) 4(50.0) 伴随症状 11.086 0.026 耳鸣 34 10(29.4) 24(70.6) 眩晕 8 4(50.0) 4(50.0) 耳鸣眩晕 21 12(57.1) 9(42.9) 耳痛 9 7(77.8) 2(22.2) 听力损失程度 7.839 0.049 轻度 12 2(16.7) 10(83.3) 中度 20 9(45.0) 11(55.0) 重度 22 12(54.5) 10(45.5) 极重度 55 33(60.0) 22(40.0) 侧别 3.251 0.197 左侧 46 15(57.7) 11(42.3) 右侧 37 22(59.5) 15(40.5) 双侧 26 15(57.7) 11(42.3) 听力曲线类型 12.482 0.006 低频下降 10 3(30.0) 7(70.0) 高频下降 11 1(9.1) 10(90.9) 平坦型 28 17(60.7) 11(39.3) 全聋型 51 31(60.8) 20(39.2) 
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表 2 不同分组突聋患儿疗效logistic回归分析
例(%) 变量 β SE Wald P Exp(β) 95%CI 下限 上限 性别 -0.309 0.488 0.402 0.526 0.734 0.282 1.910 年龄 1/4 0.981 0.851 1.329 0.249 2.666 0.503 14.124 2/4 1.305 0.716 3.323 0.068 3.686 0.907 14.989 3/4 0.849 0.705 1.451 0.228 2.337 0.587 9.302 气候 -0.486 0.492 0.976 0.323 0.615 0.235 1.613 听力损失时长 1/4 0.034 0.959 0.001 0.972 1.034 0.158 0.678 2/4 1.093 0.941 1.348 0.246 2.983 0.471 18.884 3/4 0.559 1.088 0.264 0.607 1.749 0.207 14.765 伴随症状 1/4 -1.156 1.002 1.331 0.249 0.315 0.044 2.244 2/4 0.332 1.023 0.105 0.745 1.394 0.188 10.353 3/4 1.954 1.322 2.183 0.140 7.056 0.528 94.219 听力损失程度 1/4 -2.873 1.159 6.149 0.013 0.057 0.006 0.548 2/4 -0.050 0.679 0.005 0.941 0.951 0.251 3.598 3/4 -0.378 0.820 0.213 0.645 0.685 0.137 3.415 侧别 1/3 0.381 0.676 0.317 0.573 1.464 0.389 5.509 2/3 0.192 0.534 0.130 0.719 1.212 0.426 3.453 听力曲线类型 1/4 -1.286 0.747 2.959 0.085 0.276 0.064 1.196 2/4 -2.741 1.087 6.354 0.012 0.065 0.008 0.543 3/4 -0.003 0.482 0.000 0.995 0.997 0.388 2.563
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