【摘要】 目的探讨少年儿童突发性聋临床特点、治疗及预后因素分析。方法回顾性分析2011年1月至2016年12月间我科收治的78例(81耳)儿童突发性聋的病例资料。共收集病例78例,81耳,双耳3例,其中男性40例(51.28%),女性38例(48.72%)。年龄9-18岁,平均年龄15.69岁。按照听力曲线分型,低频下降型27例,中高频下降型9例,平坦型17例,全聋型25例。分析不同类型突发性聋患儿的临床特点及治疗效果,运用logistic回归分析其预后因素。Fisher检验比较不同类型突发性聋患儿是否采用特殊治疗(鼓室/耳后注射激素)对预后的影响。结果各种类型的总有效率:低频下降型最高,为96.30%;其次为平坦型,全聋型次之,分别为76.47%,52.00%;中高频型最差,为44.44%。所有患儿总有效率为71.79%。无耳鸣患儿14例,总有效率为50%;伴耳鸣患儿64例,总有效率为76.56%。4例患儿耳后注射复方倍他米松,1例有效;21例患者采用鼓室注射甲强龙,14例有效;3例患者采用联合鼓室注射甲强龙和耳后注射复方倍他米松,1例有效。多因素Logistic回归分析结果显示,突发性聋分型、是否伴发耳鸣与少年儿童突发性聋治疗效果相关。结论低频型、伴发耳鸣的少年儿童突发性聋患者预后好,中高频型、无耳鸣的患儿预后较差。耳后注射及鼓室注射激素对首次治疗无效的患儿仍然有效。更多还原

【Abstract】 Objective To report characteristics, treatment and prognosis of sudden sensorineural hearing loss(SSNHL) in children. Methods Data from 78 children(40 boys and 38 girls, 9-18 years old, mean=15.69 years, 81 ears) with SSNHL seen from January, 2011 to December, 2016 were retrospectively analyzed. The patients were divided into 4 groups based on to their audiometric types, i.e. ascending(n=27), descending(n=9), flat(n=17) or profound(n=25). Clinical characteristics, treatment, prognostic factors were analyzed using univariate and multivariate logistic models. Results The rate of hearing improvement was 96.3% for those with ascending audiometric curves, 76.47% for those with flat audiometric curves, 52.00% for those with profound loss and 44.44% for those with descending audiometric curves, respectively. The overall recovery rate was 71.79%. The recovery rate was 50% in the 14 patients with tinnitus and 76.56% in the 64 patients without tinnitus. Hearing improved in 14 from the 21 children treated with additional intratympanic methylprednisolone as salvage treatment. Hearing improved in one of the four children who received postauricular betamethasone injection, and slightly in one of the three children treated with intratympanic methylprednisolone plus postauricular betamethasone injection. Conclusions Multivariate logistic analysis showed that type of audiometric curve and tinnitus were two independent risk factors correlated to therapeutic outcomes.更多还原