本文選題：聽覺喪失 + 突發(fā)性　； 參考：《川北醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的:對比研究經(jīng)激光鼓膜穿孔鼓室內(nèi)應(yīng)用甲潑尼龍琥珀酸鈉滴入及高壓氧治療“不良預(yù)后”突發(fā)性耳聾的療效差異。方法:將2012年12月至2014年12月住院的經(jīng)治療7天無效且符合納入及排除標(biāo)準(zhǔn)的突發(fā)性聾患者60例,隨機(jī)分為鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)和高壓氧組(對照組)。實(shí)驗(yàn)組給予激光鼓膜打孔、鼓室內(nèi)激素滴入,對照組給予高壓氧治療,兩組均同時運(yùn)用改善微循環(huán)、營養(yǎng)神經(jīng)藥物。所有患者均住院治療。對兩組病例治療前的匹配性、治療后10天及1月聽力改善、療效進(jìn)行統(tǒng)計分析。P0.05為差異具有統(tǒng)計學(xué)意義。結(jié)果:1.鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)和高壓氧組(對照組)間平均年齡、性別比、單純耳鳴患者比例、耳鳴伴眩暈患者比例、治療前聽力、患耳左右側(cè)間差異均無統(tǒng)計學(xué)意義(P0.05)。2.鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)治療前平均聽閾(Pure tone average,PTA)為84.6±20.7 d B,治療10天后PTA為62.8±27.4 d B,改善21.9±24.3d B,治療前后PTA差異有統(tǒng)計學(xué)意義(t=3.49,P0.01)。高壓氧組(對照組)治療前PTA為76.9±22.3 d B,治療10天后PTA為58.3±20.5 d B,P改善21.3±21.4 d B,治療前后PTA差異有統(tǒng)計學(xué)意義(t=3.86,P0.01)。鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)和高壓氧組(對照組)組間聽力改善差異無統(tǒng)計學(xué)意義(t=0.89,P0.05)。3.鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)治療前PTA為84.6±20.7 d B,治療1月后PTA為54.2±26.7 d B,改善30.4±15.1 d B,治療前后PTA差異有統(tǒng)計學(xué)意義(t=5.17,P0.01)。高壓氧組(對照組)治療前PTA為76.9±22.3d B,治療1月后PTA為50.7±19.3 d B,改善28.9±17.5 d B,治療前后PTA差異有統(tǒng)計學(xué)意義(t=5.38,P0.01)。鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)和高壓氧組(對照組)組間聽力改善差異無統(tǒng)計學(xué)意義(t=0.35,P0.05)。4.鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)和高壓氧組(對照組)經(jīng)治療10天,有效率分別為53.3%、43.3%,組間差異無統(tǒng)計學(xué)意義(?2=0.6007,P0.05)。5.鼓室內(nèi)激素治療組(實(shí)驗(yàn)組)和高壓氧組(對照組)經(jīng)治療1月,有效率分別為83.3%、76.7%,組間差異無統(tǒng)計學(xué)意義(?2=0.4167,P0.05)。結(jié)論:經(jīng)激光鼓膜打孔鼓室內(nèi)應(yīng)用甲潑尼龍琥珀酸鈉滴入及高壓氧治療“不良預(yù)后”突發(fā)性耳聾均有效,兩者間短期及中期療效無明顯差異�？膳R床推廣應(yīng)用。
[Abstract]:Objective: to compare the therapeutic effects of methylprednisolone sodium succinate and hyperbaric oxygen in the treatment of sudden deafness after laser tympanic membrane perforation. Methods: sixty patients with sudden deafness who were hospitalized from December 2012 to December 2014 were randomly divided into two groups: the experimental group (experimental group) and the hyperbaric oxygen group (control group). The experimental group was treated with laser perforation of tympanic membrane, hormone was dripped into tympanic chamber, and the control group was treated with hyperbaric oxygen. Both groups were treated with improving microcirculation and nourishing nerve drugs at the same time. All patients were hospitalized. Two groups of cases before treatment matching, 10 days and 1 month after treatment hearing improvement, the effect of statistical analysis. P0.05 was statistically significant difference. The result is 1: 1. There was no significant difference in average age, sex ratio, simple tinnitus patients, tinnitus patients with vertigo, hearing before treatment, left and right side of the affected ears. The average hearing threshold before treatment was 84.6 鹵20.7 dB in the experimental group and 62.8 鹵27.4 dB after 10 days of treatment, and 21.9 鹵24.3 dB was improved in the steroid treatment group (experimental group). The difference of PTA before and after treatment was statistically significant (P 0.01). In the hyperbaric oxygen group (control group), the PTA was 76.9 鹵22.3 dB before treatment, and the PTA was 58.3 鹵20.5d BNP after 10 days treatment. The difference of PTA before and after treatment was statistically significant (P < 0.01). There was no significant difference in hearing improvement between experimental group (experimental group) and hyperbaric oxygen group (control group). PTA was 84.6 鹵20.7 dB before treatment and 54.2 鹵26.7 dB after treatment in the intracympanic hormone treatment group (experimental group), and the improvement was 30.4 鹵15.1 dB. The difference of PTA before and after treatment was statistically significant (P 0.01). In the hyperbaric oxygen group (control group), PTA was 76.9 鹵22.3 dB before treatment, PTA was 50.7 鹵19.3dB after treatment for one month, and the improvement was 28.9 鹵17.5 dB. The difference of PTA before and after treatment was statistically significant (P 0.01). There was no significant difference in hearing improvement between experimental group (experimental group) and hyperbaric oxygen group (control group). After 10 days of treatment, the effective rates of hormone treatment group (experimental group) and hyperbaric oxygen group (control group) were 53.3 and 43.3, respectively. There was no significant difference between the two groups. The effective rates of steroid treatment group (experimental group) and hyperbaric oxygen group (control group) were 83.3% and 76.7% respectively. There was no significant difference between the two groups (P 0.05). Conclusion: intratympanic injection of methylprednisolone succinate sodium and hyperbaric oxygen are effective in the treatment of "poor prognosis" sudden deafness, but there is no significant difference between them in short and medium term. It can be popularized and applied in clinic.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R764.437

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