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目的:探讨不同药物及/或方法组合对突发性耳聋(suddendeafness,SD)患者的疗效及其影响因素。方法:84例(89耳)SD患者分为3组。I组24例(28耳)用脑血管扩张剂、降低血液粘滞度及内耳神经结构保护药物,II组33例(34耳),在上述药物基础上加极化液。I,II组用静脉通道给药,并用高压氧(HBO)。III组27例(27耳),全部用尼莫地平或氟桂利嗪口服,丹参制剂肌肉注射或口服,并用神经结构保护剂,不用HBO。结果:3组有效率依次为67.86%,64.71%,70.37%,χ2检验差异不显著;不同听力曲线对疗效有影响,低频型有效率为84.6%,高频型有效率为44.4%;于发病7d内治疗的病例最有效,痊愈及显效率为77.8%及94.7%,1个月以后少数病例有效;治疗15d总有效率为50.8%,至30d已达84.7%。结论:3组患者用不同药物及/或不同方法组合,疗效差异不明显,应以用改善内耳微循环、降低血液粘滞度、保护内耳神经结构的药物为主;HBO、极化液并不一定能提高疗效;对SD宜早期治疗,发病7天内疗效最好,疗程以15～30d为宜。
Objective: To investigate the efficacy and influencing factors of different drugs and / or combination of methods in patients with sudden deafness (SD). Methods: Eighty-four SD patients (89 ears) were divided into three groups. Group I 24 cases (28 ears) with cerebral vasodilator to reduce blood viscosity and the inner ear nerve structure protection drugs, group II 33 cases (34 ears), in addition to the above drugs based on the polarization solution. Groups I and II were given intravenous access and hyperbaric oxygen (HBO). Group III 27 cases (27 ears), all with nimodipine or flunarizine orally, Salvia formulations intramuscular or oral administration, and the use of neuroprotective agents, without HBO. Results: The effective rates of the three groups were 67.86%, 64.71% and 70.37%, respectively. There was no significant difference between the two groups in the χ2 test. Different hearing curves had an effect on the curative effect. The effective rate of low frequency type was 84.6% and high frequency type was 44.4% In 7d, the most effective treatment, recovery and effective rates were 77.8% and 94.7%, a few cases after 1 month effective; 15d total effective rate was 50.8%, reached 30 days reached 84.7%. Conclusion: The three groups of patients with different drugs and / or combination of different methods, the effect was not obvious, should be used to improve the microcirculation of the inner ear, reduce blood viscosity, protect the inner ear nerve structure of the drug-based; HBO, Will be able to improve the efficacy; SD should be early treatment, the best effect within 7 days of onset, treatment to 15 ~ 30d appropriate.