本文關鍵詞： 主觀性耳鳴 掩蔽 療效 相關因素　出處：《鄭州大學》2011年碩士論文　論文類型：學位論文

【摘要】：目的： 探討主觀性耳鳴的治療及影響療效與預后的相關因素。 方法： 對2010年7月至2011年2月就診于鄭州大學第一附屬醫(yī)院耳科門診的以耳鳴為第一主訴的患者,行客觀檢測包括純音測聽、聲導抗、耳聲發(fā)射、耳鳴檢測(耳鳴響度和頻率匹配、耳鳴掩蔽曲線、殘余抑制試驗),篩選出確診為主觀性耳鳴且殘余抑制試驗陽性的患者191例。治療前詢問病史,給予病情分級。使用改善微循環(huán)等藥物,同時輔以掩蔽治療,每天三次,每次30分鐘,并隨著患者病情變化調整掩蔽聲頻率和強度,每個療程15天,堅持至少兩個療程。結果： 據本資料統(tǒng)計,191例患者中2級耳鳴33例,3級耳鳴83例,4級耳鳴55例,5級耳鳴12例,6級耳鳴8例。病程1天-15年；短于3月的68例,3月至15年的123例；有噪聲接觸史的23例；伴有三高(高血壓、高血糖、高血脂)的53例,聽力正常的49例,輕度聽力損失者65例,中度聽力損失者64例,重度聽力損失者13例。經治療后痊愈16例,顯效27例,有效57例,無效91例,總有效率52.6%。將病人按照病程、有無三高,有無噪聲接觸史以及聽力損失程度分組,計算有效率,并進行統(tǒng)計學分析,主觀性耳鳴的療效與病程、有無三高、有無噪聲接觸史顯著相關；其療效與聽力損失程度關系無統(tǒng)計學意義。 結論： 耳鳴預后與耳鳴發(fā)病時間的長短、是否伴有三高、是否有噪聲接觸史等有關,與聽力損失程度關系不大。發(fā)病時間長、伴有三高、有噪聲接觸史的患者療效不理想�；颊甙l(fā)病應及時就診,伴有三高的患者需在治療耳鳴的同時進行規(guī)范的控制血壓血脂及血糖的治療,患者應有健康的心理狀態(tài),相信耳鳴可以治愈。
[Abstract]:Objective: Objective: to explore the treatment of subjective tinnitus and the related factors affecting curative effect and prognosis. Methods: From July 2010 to February 2011, we examined the patients with tinnitus as the first complaint, including pure tone audiometry, acoustic conductance, and otoacoustic emission in the otological clinic of the first affiliated Hospital of Zhengzhou University. Tinnitus test (tinnitus loudness and frequency matching, tinnitus masking curve, residual inhibition test), 191 patients with subjective tinnitus and positive residual inhibition test were selected. The patients were given disease grade. The patients were treated with drugs such as improving microcirculation and masking for 30 minutes three times a day. The frequency and intensity of masking sound were adjusted for 15 days with the change of the patient's condition. Maintain at least two courses of treatment. Results: According to the data, 33 cases of grade 2 tinnitus, 83 cases of grade 3 tinnitus, 55 cases of grade 4 tinnitus, 55 cases of grade 5 tinnitus, 12 cases of grade 6 tinnitus, 8 cases of grade 6 tinnitus, the course of disease was from 1 day to 15 years. It was shorter than 68 cases on March and 123 cases from March to 15 years. 23 cases had a history of noise exposure; There were 53 cases with high blood pressure, hyperglycemia and hyperlipidemia, 49 cases with normal hearing, 65 cases with mild hearing loss and 64 cases with moderate hearing loss. After treatment, 16 cases were cured, 27 cases were effective, 57 cases were effective, 91 cases were ineffective, and the total effective rate was 52.6%. Whether there was any history of exposure to noise and the degree of hearing loss were divided into groups, the effective rate was calculated, and statistical analysis was made. The curative effect of subjective tinnitus was significantly correlated with the course of disease, whether there were three high levels or not, and whether there was any history of noise exposure. There was no significant relationship between the curative effect and the degree of hearing loss. Conclusion: The prognosis of tinnitus is related to the duration of tinnitus onset, whether there are three high, whether there is a history of noise exposure, and so on, but not related to the degree of hearing loss. Patients with noise-exposed history of treatment should be timely treatment, accompanied by three high patients should be in the treatment of tinnitus at the same time standardized control of blood pressure, blood lipid and blood sugar treatment. Patients should have a healthy psychological state, I believe tinnitus can be cured.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R764

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