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目的 探讨高压氧(hyperbaric oxygen,HBO)综合治疗突发性耳聋患者的临床疗效.方法选取解放军第一○五医院耳鼻咽喉头颈外科2015年6月至2017年3月收治的突发性耳聋患者80例,按就诊时间顺序分为观察组和对照组,每组40例.对照组予以扩容改善血液流变学、扩血管改善微循环、糖皮质激素、营养神经药物等常规治疗,观察组在对照组治疗的基础上给予HBO治疗.2组均以10 d为1个疗程,治疗3个疗程后比较2组患者治疗前后听力变化情况及其临床疗效.结果治疗3个疗程后,观察组治愈4例,显效21例,有效10例,无效5例,治疗总有效率为87.5％;对照组无治愈病例,显效5例,有效22例,无效13例,治疗总有效率为67.5％,2组比较差异有统计学意义(P<0.05).2组患者治疗前全频听力损失值比较差异无统计学意义(P>0.05),经治疗2个疗程后观察组低频听力提高值较对照组明显改善[(37.39±5.77)vs(23.91±4.08)dB,P<0.05],高频听力提高值2组比较无统计学差异(P>0.05).治疗3个疗程后观察组低频和高频听力提高值较对照组均明显改善[低频:(45.99±5.98)vs(36.79±5.72)dB,高频:(19.63±3.94)vs(9.70±2.17)dB,P<0.05].结论HBO综合治疗全频听力损失突发性耳聋可显著改善患者的听力水平,值得临床进一步推广应用.

Objective To investigate the clinical efficacy of comprehensive hyperbaric oxygen (HBO) in the treatment of the patients with sudden hearing loss .Methods Totally, 80 patients with sudden hearing loss who were admitted into our hospital for treatment from June 2015 to March 2017 were selected as research subjects, and were divided into the observation group (n =40) and the control group (n =40), in accordance with the sequence of admission.The control group was given volume expansion to improve hemorheology , vasodilator to improve microcirculation, glucocorticoids, neurotrophic drugs and ginkgo biloba extract dripping pills, while the observation group received HBO in addition to the treatment received by the control group .One course of treatment for all patients in the 2 groups was 10 days, and following 3 courses of treatment, changes in hearing and clinical efficacy before and after treatment for the patients of the 2 groups were compared between the 2 groups.Results Following treatment for 3 courses for the observation group , 4 cases were cured, 21 cases were markedly effective , 10 cases were effective and 5 cases were ineffective, with a total effective rate of 87.5％, while for the control group, no cases were cured, 5 cases were markedly effective, 22 cases were effective and 13 cases were ineffective, with a total effective rate of 67.5％.Statistical significance could be seen, when comparisons were made between the observation group and the control group (P <0.05).Before treatment, there was no significant differences in full frequency hearing loss for the patients of 2 groups (P >0.05).After 2 courses of treatment, the value of low frequency hearing for the observation group increased more significantly, as compared with that of the control group [(37.39 ±5.77) vs (23.91 ±4.08) dB,P <0.05], however, there were no statistical differences in the increased values of high frequency hearing , when comparisons were made between the 2 groups (P >0.05).After 3 courses of treatment, the increased values of both low frequency and high frequency hearing for the patients of the observation group were all significantly better than those of the control group [ low frequency: (45.99 ±5.98) vs (36.79 ±5.72) dB; high frequency:(19.63 ±3.94) vs (9.70 ±2.17)dB, P <0.05].Conclusions Comprehensive HBO treatment could effectively improve the hearing level of the patients with full frequency sudden hearing loss , which was worth further clinical popularization .