突發(fā)性耳聾伴眩暈的前庭自旋轉(zhuǎn)試驗(yàn)結(jié)果分析
[Abstract]:objective
Sudden deafness (sudden deafness, SD) is a common ear disease in otolaryngology head and neck surgery. It is an unknown cause of sudden hearing loss in a short period of time. Most of them are considered to be related to internal ear microcirculation disorder, virus infection, rupture of the window membrane, allergy, dysfunction of blood tube and metabolic disorders. It is often accompanied by vertigo, so the study of vestibular function in patients with sudden deafness is becoming more and more in-depth. The current study shows vestibular dysfunction through the examination of the vestibular function of sudden deafness, and the vestibular function has a certain influence on the prognosis of sudden deafness. Vestibular self rotation test (Vestibular A) Utorotation Test, VAT) is one of the new high frequency examination methods to evaluate vestibular function through the vestibular eye movement reflex (/estibulo-ocular Reflex, VOR). The frequency range is 2 to 6.0Hz, and its frequency range is close to the normal motion frequency of human daily life. It should be widely used for the examination of vestibular diseases and the evaluation of vestibular function. VAT results of patients with sudden deafness and vertigo were compared and analyzed, and the characteristics and causes of sudden deafness and vertigo were discussed in order to provide a reliable and effective basis for the evaluation of the vestibular system and the vestibular rehabilitation in patients with sudden deafness.
Method
The normal control group, the patients with sudden deafness and vertigo, was studied in the experimental group. The normal control group was 78 cases of medical staff and family members in our hospital, 41 males and 37 females, the average age of 10~82 years, the average age of 44.8 + 9.4 years, and the normal hearing and visual acuity, without the history of ear science related (such as tinnitus deafness, otitis media, nor flat) There were no hypertension, diabetes, cardiovascular and cerebrovascular diseases, neurologic diseases, cervical spondylosis, and non-smoking alcohol addiction. The experimental group were 229 cases of sudden deafness and vertigo in the Department of Otolaryngology and head and neck surgery of Tianjin First Central Hospital from March 2009 to May 2011, 97 men, 132 women, 14~79 years old, and flat. All 49.7 + 11.6 years of age. The diagnosis of sudden deafness accords with the diagnostic basis established by the Chinese Medical Association of otorhinolaryngology. Neurologic examination has no signs of central lesions, imaging to exclude acoustic neuroma, cerebral ischemia or hemorrhagic lesions. Two groups of studies on the image were performed by the American WSR VAT detector, and the vertical VAT test was used for.VAT detection. There are five indexes of horizontal eye movement gain, vertical eye movement gain, horizontal eye movement phase, vertical eye movement phase, and horizontal eye movement. The gain is equal to the eye movement speed / head speed, it is the strength index of VOR, the normal gain is close to 1, the abnormal result is high, and the low gain is two. The essence of the phase is the eye movement information corresponding to the head moving input information. The difference in time represents the response sensitivity of VOR to the appropriate stimulus, and the results of the VOR phase anomaly are high and low phase two, both of which are phase retardation, and the high phase indicates a more serious phase delay. The asymmetric value is taken from the eye movement velocity ratio in the direction of each frequency, indicating the intensity difference between the left and right vestibule system functions. The asymmetric normal reference value of each frequency is 0 + 10%, the negative value is on the left side, and the positive value is right. In the VAT level and the vertical test gain and phase, one or more anomalies occur in the horizontal asymmetric five parameter index, which is evaluated as the test positive, the gain and the phase any exception in the horizontal or vertical test are all recorded as Gain or phase anomaly. Statistical analysis is applied to SPSS16.0 statistical software. The measurement data is expressed in mean number of standard deviation (x + s) or median, and the normal distribution is tested. The count data is expressed as a percentage, and the difference between the t test and the chi 2 test.P0.05 is statistically significant.
Result
The comparison between the 1 control groups and the normal reference values of the system: the mean and the reference values of the four indexes of the control group, the horizontal gain, the horizontal phase, the vertical gain and the vertical phase in the frequency band of 2,3,4,5,6Hz, were not statistically significant, and the mean and reference value of the P0.05. asymmetric value at the frequency of 2,3,4,5,6,7,8,9,10Hz was compared with the reference value. The difference was not statistically significant, P0.05.
2 Analysis of the results of the 2 experimental group: 214 cases (93.4%) were abnormal in 229 cases in the experimental group, 156 cases (68.1%) with abnormal gain, 182 cases (79.5%) and 143 (62.4%) with unsymmetrical abnormality.
2.1 gain abnormality included only 103 cases (44.9%), only 19 cases (8.3%) and 34 cases (14.8%) of horizontal gain and vertical gain, high gain 92 (40.2%) and 98 low gain (42.8%). The difference was not statistically significant, P0.05; high gain in the level gain 64 cases (27.9%), low increase. 73 cases (31.9%), the two were compared with the chi square test, the difference was not statistically significant, P0.05, the high gain in the vertical gain 28 cases (12.2%), the low gain 25 cases (10.9%), the two compared with the chi square test, the difference was not statistically significant, P0.05.
2.2 phase abnormalities include only 47 cases (20.5%), only 65 cases (28.4%) and 70 cases (30.6%) of horizontal and vertical phase anomalies; high phase 198 cases (86.5%), 54 cases of low phase (23.6%), two, statistically significant difference, P0.05, 65 cases (28.4%), low phase in high phase in horizontal phase, low phase There were 52 cases (22.7%), the two were compared with the chi square test, the difference was not statistically significant, P0.05, the high phase in the vertical phase was 133 cases (58.1%), the low phase was 2 cases (0.9%), the two were compared with the chi square test, the difference was statistically significant, P0.05.
The 3 control group compared with the experimental group.
The VAT positive results between the 3.1 control group and the experimental group were compared: the abnormal rate of VAT in the control group was 9% (7 cases), the gain abnormal rate was 5.1% (4 cases), the phase abnormal rate was 6.4% (5 cases), and the asymmetric abnormal rate was 3.8% (3 cases); the abnormal rate of VAT in the experimental group was 93.4%. (214), the gain abnormal rate was 68.1% (156 cases), and the phase anomaly rate was the non pair. The abnormal rate was 62.4% (143 cases). The positive rates of the above two groups were compared with chi square test, and the P values were all =0.000, the differences were statistically significant.
3.2 the comparison of the five indicators of VAT between the control group and the experimental group was:
3.2.1 two groups of horizontal gain comparison: the average value of the frequency band of 2,3,4,5,6Hz is compared with t test, and there is no significant difference in the mean value of the two groups at 4Hz, P0.05, the difference of the average level gain of the two groups at 2,3,5,6Hz is statistically significant, and the P value is 0.05.
3.2.2 two groups of horizontal phase comparison: the average value of the frequency band of 2,3,4,5,6Hz is compared with t test. There is no significant difference in the mean phase mean difference between the two groups at 2Hz, P0.05, the difference of the average level of the horizontal phase in the two groups of 3,4,5,6Hz is statistically significant, and the P value is 0.05.
3.2.3 two groups of vertical gain comparison: the average value of the frequency band of 2,3,4,5,6Hz is compared with t test. There is no statistically significant difference in the mean value of vertical gain in the two groups at 3,4,5Hz, P0.05, the difference of the mean value of the vertical gain in the two groups of 2,6Hz is statistically significant, and the P value is 0.05.
3.2.4 Two groups of vertical phase comparison: in the frequency of 2,3,4,5,6 Hz band mean comparison t test, the difference was statistically significant, P value was 0.05.
3.2.5 Comparisons of asymmetric results between the two groups: T-test for mean values at frequencies of 2,3,4,5,6,7,8,9,10 Hz showed statistically significant differences (P 0.05).
conclusion
The normal value of VAT in our laboratory coincide with the reference value of the system. Results the gain index of an objective and reliable.VAT can have high gain and low gain in patients with sudden deafness and vertigo. High gain suggests vestibular hypersplenism in vestibular central function, and low gain suggests a decrease in the ability of vestibular terminal induction. It is related to the extent of the cause of the vestibule and the range of vestibule injury. The phase index of the patients with sudden deafness and vertigo is characterized by high vertical phase full frequency, suggesting that the vestibule reflex delay is delayed. Its asymmetry is abnormal. It can suggest that the gain index of the diseased side.VAT is beneficial to the vestibular system loss in the patients with sudden deafness and vertigo. Qualitative assessment and etiological analysis of injury.
【學(xué)位授予單位】:天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2012
【分類號(hào)】:R764.04
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