【摘要】：目的分析妊娠期突發(fā)性聾臨床表現(xiàn)特點(diǎn),探討安全有效的治療措施。方法分析2005年6月到2013年12月間21例妊娠期突發(fā)性聾的臨床表現(xiàn)特點(diǎn)及診療經(jīng)過、療效。突發(fā)性聾的診斷及療效評(píng)估參照2005年濟(jì)南會(huì)議的標(biāo)準(zhǔn),治療過程中觀察純音聽力恢復(fù)情況。治療方案:發(fā)病3天以內(nèi)中度以下低中頻型聾2例,首選門診隨診觀察,其余19例選擇藥物治療:①低分子右旋糖酐-40500ml靜脈點(diǎn)滴每天1次,14天為1療程,聽力恢復(fù)則隨時(shí)停藥;同時(shí)口服強(qiáng)的松,按照1mg/kg體重開始,每日總量不超過60mg,其后每3天減少10mg;如低分子右旋糖酐-40皮試過敏,改備用方案:②葛根素注射液250ml靜脈點(diǎn)滴及口服強(qiáng)的松,療程同方案①。治療過程由產(chǎn)科醫(yī)生負(fù)責(zé)超聲監(jiān)測胎兒是否存在畸形、宮內(nèi)發(fā)育遲緩、低體重。對(duì)經(jīng)治病例進(jìn)行半年以上的母嬰健康狀況隨訪,內(nèi)容為母親聽力及肝腎功能、兒童的生長發(fā)育、智力及聽力言語情況。結(jié)果治療前純音聽力曲線包括低中頻下降型6例(6耳)、平坦型7例(7耳)、全聾5例(5耳)、覆盆型1例(1耳)、峰型1例(雙耳),槽型1例(1耳)。痊愈13例,顯效3例,有效2例,無效3例。隨訪0.5~5年,母嬰健康。結(jié)論妊娠期間突發(fā)性聾的治療需謹(jǐn)遵孕婦用藥原則,低分子右旋糖酐、葛根素及強(qiáng)的松治療妊娠期間突發(fā)性耳聾的療效顯著,在治療及隨訪期內(nèi)未發(fā)現(xiàn)明顯不良反應(yīng),中度以下低中頻型聾有自愈傾向,發(fā)病3天以內(nèi)的患者可首選門診隨診觀察。
[Abstract]:Objective To analyze the clinical features of sudden deafness in pregnancy and to explore the safe and effective treatment measures. Methods The clinical features and curative effect of 21 cases of sudden deafness during the period from June 2005 to December 2013 were analyzed. The diagnosis and curative effect evaluation of sudden deafness refers to the standard of Jinan conference in 2005, and the hearing recovery of pure tone is observed in the course of treatment. The treatment scheme:2 cases with low intermediate-frequency-type deafness with moderate or lower middle-frequency-type deafness within 3 days of the attack, and the first preferred out-patient follow-up observation. The remaining 19 cases were treated with the following drugs:1 time per day for low-molecular-low-molecular dexterotonin-40500ml intravenous drip,1 course of treatment for 14 days, and the hearing recovery was stopped at any time; and the oral prednisone was also taken orally. At the beginning of 1 mg/ kg body weight, the total daily amount was not more than 60 mg, followed by a decrease of 10 mg every 3 days; for example, the low-molecular right-rotation sugar-40 skin test had an allergic reaction, and the alternative was changed: the injection of puerarin injection 250ml intravenous drip and oral prednisone, and the course of treatment was the same as that of the protocol. In the course of treatment, the obstetrician is responsible for the ultrasonic monitoring of the presence of malformations, intrauterine growth retardation, and low body weight. The follow-up of mother-to-child health status for more than half a year of the treated case is the mother's hearing and the function of the liver and the kidney, the development of the child, the intelligence and the hearing. Results The pre-treatment pure tone hearing curve consisted of 6 (6 ears),7 (7 ears),5 (5 ears),1 (1 ears),1 (2 ears) and 1 (1 ears) of the low IF descending type,7 (7 ears),5 (5 ears),1 (1 ears),1 (2 ears) and 1 (1 ears). 13 cases were cured,3 cases were markedly effective,2 cases were effective, and 3 cases were ineffective. The follow-up period was 0.5 to 5 years, and the mother-to-child health was Conclusion The treatment of sudden deafness during pregnancy should be in accordance with the principle of the use of pregnant women, the obvious curative effect of low-molecular, right-rotation, puerarin and prednisone in the treatment of sudden deafness during pregnancy, no obvious adverse reaction is found during the treatment and follow-up period, and the low-intermediate-frequency-type deafness with moderate or lower middle-frequency type has self-healing tendency. The patients within 3 days of the onset of the disease may be selected for outpatient visit.
【作者單位】： 中山大學(xué)附屬三院耳鼻咽喉頭頸外科;江西省武寧縣人民醫(yī)院;
【基金】：廣州市科技計(jì)劃項(xiàng)目2013KP089
【分類號(hào)】：R764.431

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