本文選題：突發(fā)性耳聾 + 療效　； 參考：《河北醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的:突發(fā)性耳聾(Sudden deafness,SD )是指突然發(fā)生的原因不明的感音神經(jīng)性聽力損失,聽力一般在72小時內(nèi)下降到最低點(diǎn),其發(fā)病為10萬分之5到7。關(guān)于其病因及發(fā)病機(jī)制目前一直未明,目前存在多種學(xué)說,包括微循環(huán)障礙、感染、自身免疫、窗膜破裂和代謝障礙等,(1)微循環(huán)障礙學(xué)說:認(rèn)為內(nèi)耳血栓形成、栓子栓塞、血流量下降、血管痙攣等引起耳蝸血流灌流減少,使內(nèi)耳缺血、缺氧,最終導(dǎo)致內(nèi)耳毛胞壞死和退行性改變;(2)感染學(xué)說:直接和間接的證據(jù)證明突聾和病毒感染相關(guān),部分突聾患者有上呼吸道感染病史,突聾患者的血液中發(fā)現(xiàn)病毒抗體,病毒原體可通過不同的作用方式直接或間接引起內(nèi)耳損傷;(3)免疫學(xué)說:認(rèn)為原發(fā)性免疫病局限于內(nèi)耳或是繼發(fā)于全身性的自身免疫性疾病可引起內(nèi)耳的損傷;(4)窗膜破裂學(xué)說:認(rèn)為氣壓傷、外傷、跳水等原因引起的內(nèi)耳壓強(qiáng)改變可以導(dǎo)致窗膜破裂,表現(xiàn)為突發(fā)性耳聾。突發(fā)性耳聾的治療方法有多種,包括擴(kuò)血管藥物、抗病毒藥物、吸入混合氧、維生素類、口服或鼓室注射糖皮質(zhì)激素等,但是目前何種治療最有效果尚不明確,尚無直接證據(jù)。因此探討突發(fā)性耳聾的病因、臨床特點(diǎn)及影響突發(fā)性耳聾患者預(yù)后的因素有一定意義,并可指導(dǎo)臨床治療。 方法:選擇我院2007.9—2010.2收治的有詳細(xì)病史資料的76例突發(fā)性耳聾患者進(jìn)行回顧性分析,入院時對病人進(jìn)行詳細(xì)查體,仔細(xì)詢問病史,全部病人均行純音測聽、聲導(dǎo)抗檢查,部分患者腦干誘發(fā)電位、眼震電圖檢查、必要的放射學(xué)檢查(頭顱及內(nèi)聽道CT、MRI等)檢查,排除相關(guān)疾病。把患者的年齡、性別、耳別、就診時間、耳聾程度、耳聾類型、眩暈、耳鳴、全身疾病情況、療效進(jìn)行列表,分析突聾的病因、臨床特點(diǎn),并采用x2檢驗(yàn),探討年齡、性別、耳別、就診時間、耳聾程度、耳聾類型、眩暈、耳鳴、全身疾病情況與預(yù)后的關(guān)系。 結(jié)果:突聾患者發(fā)病率較高,男女性別無明顯差異,年齡以40—60歲為多(47例,占61.84% ),單側(cè)聾為主(72例占94.74%),4例表現(xiàn)為雙側(cè)聾,52例患者(68.4%)伴耳鳴,18例患者(23.7%)伴眩暈。經(jīng)x2檢驗(yàn),患者年齡、耳聾程度、耳聾類型、伴隨眩暈、就診時間與預(yù)后相關(guān),耳別、性別、耳鳴與預(yù)后無明顯關(guān)系。 結(jié)論:突發(fā)性耳聾是耳鼻喉科常見病,其發(fā)病率逐年上升,對突發(fā)性耳聾患者要詳細(xì)查體,治療突聾時,應(yīng)全面考慮各種影響預(yù)后的因素,針對病因進(jìn)行病因及對癥采取綜合治療,盡量提高治愈率。
[Abstract]:Objective: sudden deafness (Sudden deafnessle SD) refers to the sudden onset of sensorineural hearing loss of unknown origin, which generally decreases to its lowest level within 72 hours, and its incidence ranges from 5 to 7 per 100,000. There are many theories, including microcirculation disorder, infection, autoimmunity, window membrane rupture and metabolic disorder. Decreased blood flow, vasospasm and other causes of cochlear perfusion, ischemia and hypoxia in the inner ear, eventually leading to hair cell necrosis and degenerative changes in the inner ear. Infection theory: direct and indirect evidence that sudden deafness is associated with viral infection. Some patients with sudden deafness had a history of upper respiratory tract infection, and virus antibodies were found in the blood of patients with sudden deafness. Viroplasma can cause inner ear injury directly or indirectly in different ways. Immunology says: it is believed that primary immune disease is limited to the inner ear or secondary to systemic autoimmune disease can cause damage to the inner ear. The theory of membrane rupture: it is believed that air pressure injury, Trauma, diving and other causes of pressure changes in the inner ear can lead to rupture of the window membrane, showing sudden deafness. There are many treatments for sudden deafness, including vasodilators, antiviral drugs, inhaled mixed oxygen, vitamins, oral or tympanic injection of glucocorticoids, etc. Therefore, it is of significance to explore the etiology, clinical characteristics and prognostic factors of sudden deafness, and to guide clinical treatment. Methods: 76 patients with sudden deafness who were admitted to our hospital from July to February 2007.9-2010.2 were analyzed retrospectively. The patients were examined in detail on admission, and their history was inquired carefully. All patients were examined by pure tone audiometry and acoustic conductance test. Brain stem evoked potential (BAEP), electronystagmogram (ENG), and necessary radiologic examination (CT MRI, etc.) were used to exclude the related diseases in some patients. Age, sex, ear type, time of visit, degree of deafness, type of deafness, vertigo, tinnitus, disease of the whole body, curative effect were listed, the etiology and clinical characteristics of sudden deafness were analyzed, and the age and sex were studied by using x2 test. The relationship between prognosis and ear classification, time, degree of deafness, type of deafness, vertigo, tinnitus, systemic disease. Results: the incidence of sudden deafness was higher, and there was no significant difference between male and female. 47 cases (61.84%) were aged 40-60 years old, and 72 cases (94.7444%) were unilateral deafness, which showed bilateral deafness in 52 cases (68.4%) and tinnitus in 18 cases (23.7%) with vertigo. By x2 test, age, degree of deafness, type of deafness, accompanied by vertigo, the time of seeing a doctor was related to prognosis, ear type, sex, tinnitus and prognosis were not significantly related to the prognosis. Conclusion: sudden deafness is a common disease in the department of otolaryngology. The incidence of sudden deafness is increasing year by year. To improve the cure rate by comprehensive treatment for etiology and syndrome.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R764

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 劉文波;楊聰;;雙耳突聾與單耳突聾的臨床對比分析[J];當(dāng)代醫(yī)學(xué);2012年01期

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本文編號：1962576