本文選題：細(xì)菌性腦膜炎　切入點(diǎn)：聽力障礙　出處：《廣西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討細(xì)菌性腦膜炎(Bacterial Meningitis, BM)患者聽力障礙(又稱耳聾)的發(fā)生率及可能的影響因素。 方法：收集2007年1月至2012年1月廣西醫(yī)科大學(xué)第一附屬醫(yī)院BM患者172例,其中78例進(jìn)行了純音測(cè)聽(Pure tone audiometry, PTA)、聽性腦干誘發(fā)電位(Auditory brainstem responses, ABR)、聲導(dǎo)抗(鼓室圖、聲反射)檢測(cè),根據(jù)結(jié)果將BM分為BM聽力障礙組、BM無聽力障礙組。收集無BM對(duì)照組56例,進(jìn)行PTA或ABR檢測(cè)。用Logistic回歸分析判斷BM患者聽力障礙的影響因素。 結(jié)果：1、BM患者聽力障礙發(fā)生率39.7%(31/78)高于正常對(duì)照組聽力障礙的發(fā)生率7.1%(4/56),P＜0.05。＜18歲BM患者聽力障礙發(fā)生率24.4%(10/41),≥18歲聽力障礙發(fā)生率56.8%(21/37)�！�18歲BM患者比＜18歲者有更高的聽力障礙發(fā)生率(56.8%vs24.4%, P0.05)。2、 BM患者感音神經(jīng)性耳聾(Sensorineural Hearing Loss,SNHL)發(fā)生率83.9%(26/31),雙邊耳聾發(fā)生率80.6%(25/31),雙耳重度以上耳聾發(fā)生率41.9%(13/31),雙耳極重度以上耳聾發(fā)生率19.4%(6/31),固定性耳聾發(fā)生率83.9%(26/31)。3、單因素分析示腦膜刺激征陽(yáng)性(OR=3.938).CSF糖≤1.0mmol／L (OR=6.224).血CRP≥20mg/L (OR=4.667)、年齡≥18歲(OR=4.069)是BM聽力障礙的危險(xiǎn)因素,P＜0.05；使用激素(B=-1.342,OR=0.261)、使用甘露醇(B=-1.042,OR=0.353)是聽力障礙的保護(hù)因素,P＜0.05。多因素Logistic回歸分析示腦膜刺激征陽(yáng)性(P=0.003,OR=12.454)、 CSF糖≤1.0mol/L (P=0.030,OR=8.322)是聽力障礙的高危因素。 結(jié)論：1、BM伴聽力障礙發(fā)生率較高(39.7%)。2、BM聽力障礙多為SNHL.雙邊耳聾、雙耳重度以上耳聾、固定性耳聾。3、腦膜刺激征陽(yáng)性、CSF糖≤1.0mmol／L、血CRP≥20mg／L、年齡≥18歲是BM聽力障礙的危險(xiǎn)因素,使用激素、使用甘露醇是BM聽力障礙的保護(hù)因素。多因素Logistic回歸分析示CSF糖≤1.0mmol／L、腦膜刺激征陽(yáng)性是聽力障礙的高危因素。
[Abstract]:Objective: to investigate the incidence of hearing impairment (also called deafness) in patients with bacterial meningitis (BMM) and its possible influencing factors. Methods: from January 2007 to January 2012, 172 cases of BM patients in the first affiliated Hospital of Guangxi Medical University were collected. Among them, 78 cases were examined by pure tone audiometry, auditory brainstem evoked potential (BAEP), auditory brainstem evoked potential (ABR), acoustic conductance (tympanogram, acoustic reflex). According to the results, BM was divided into BM hearing impairment group and BM without hearing disorder group, 56 cases of non-BM control group were collected and detected by PTA or ABR. Logistic regression analysis was used to determine the influencing factors of hearing impairment in BM patients. Results the incidence of hearing impairment in the patients with 1: 1 / BM was 39.7 / 78), which was higher than that in the normal control group (7.1 / 56) (P < 0.05). The incidence of hearing impairment in patients with BM < 18 years old was 24.410 / 41%, and the incidence rate of hearing disorders 鈮，

本文編號(hào)：1633557