妊娠期突发性聋发病特点及疗效分析

Characteristics and curative effect analysis of patients during pregnancy with sudden deafness

摘要:

目的：探讨妊娠期突发性聋患者发病特点及疗效分析。方法：通过回顾性研究2015年8月1日至2018年6月30日收治的88例妊娠期突发性聋患者（包括门诊和入院患者）纳入实验组，根据2015年突发性聋诊疗指南，分为平坦型26例，全聋型62例，发病到就诊时间小于15 d，排除激素使用禁忌证，同时给予口服激素和鼓室注射，患者治疗后1、2、4周及3个月纯音测听结果进行疗效分析。并选择同期住院治疗的88例突发性聋患者进入对照组，平坦型26例，全聋型62例为对照（女性，排除妊娠）。结果：实验组以平坦型和全聋型最为常见，其中妊娠中期30例，后期58例，总有效率为39.77%（35/88）。妊娠全聋型治疗痊愈率为0（0/62），显效率为14.52%（9/62），有效率为24.19%（15/62）；妊娠平坦型治疗痊愈率为0（0/26），显效率为19.23%（5/26），有效率为23.08%（6/26）。对照组全聋型痊愈率为6.45%（4/62），显效率为27.42%（17/62），有效率为38.71%（24/62）。对照组平坦型痊愈率为7.69%（2/26），显效率为34.62%（9/26），有效率为38.46%（10/26）。对照组总有效率为75%（66/88）。实验组和对照组总有效率相比，差异有统计学意义（P＜0.05）。实验组全聋型、平坦型分别与对照组全聋型、平坦型相比，差异有统计学意义（P＜0.05）。所有患者婴幼儿出生时评分均正常，随访3个月均健康。结论：妊娠突发性聋以全聋型最为常见，其次为平坦型，即妊娠期发病时听力损失较重，其治疗显效率、有效率均较普通突发性聋效果差，但仍需要进一步加大样本量；口服激素联合鼓室注射是一种安全的治疗方法。

Abstract:

Objective：To investigate the characteristics and treatment outcome of patients during pregnancy with sudden deafness. Methods：A retrospective study was conducted on 88 cases of sudden deafness during pregnancy who were admitted from August 1，2015 to June 30，2018（including outpatients and hospitalized patients）. According to the guidelines for diagnosis and treatment of sudden deafness in 2015，there were 26 cases of flat type and 62 cases of total deafness. For these cases，the time from onset to visit was less than 15 days，and those with contraindications to hormones were excluded from the study. Oral hormone and intratympanic injection were then given at the same time. The results of pure tone audiometry at 1，2，and 4 weeks and 3 months after treatment were analyzed for curative effect analysis. Another 88 patients with sudden deafness who were hospitalized in the same period were selected as control group，consisting of 26 cases of flat type and 62 cases of total deafness（female，no pregnancy）. Results：Flat type and total deafness are the most common types in the experimental group，including 30 cases in the second trimester of pregnancy and 58 cases in the third trimester. In this group，the overall response rate was 39.77%（35/88）. And the cure rate，marked response rate，and response rate of total deafness were 0%（0/62），14.52%（9/62），and 24.19%（15/62），respectively，while the corresponding rates of flat type were 0%（0/26），19.23%（5/26），and 23.08%（6/26），respectively. Regarding the control group，the overall response rate，marked response rate，and response rate of total deafness were 6.45%（4/62），27.42%（17/62），and 38.71%（24/62），respectively. And the corresponding rates of flat type in the control group were 7.69%（2/26），34.62%（9/26），and 38.46%（10/26），respectively. The overall response rate was 75%（66/88） in the control group. There was a significant difference between the experimental group and the control group in terms of the overall response rate（P<0.05）. There were also significant differences with respect to the subjects of total deafness and flat type between these two groups（P<0.05）. All infants’ Apgar scores were normal at birth and they were all healthy during 3 months of follow-up. Conclusion：Total deafness is the most common type of sudden deafness in pregnancy，followed by flat type，with severe hearing loss during pregnancy. And the marked response rate and response rate are worse than those of common sudden deafness，but the sample size still needs to be further increased. Altogether，oral hormone combined with intratympanic injection is a safe treatment.