妊娠期突发性聋的临床特点及预后分析

Clinical Characteristics and Prognosis of Sudden Sensorineural Hearing Loss during Pregnancy

石大志;肖娟;杨丽;罗志强;

1:南华大学附属第二医院耳鼻咽喉头颈外科

摘要

目的分析妊娠期突发性聋(简称突聋)患者的临床特点及预后,为该病的临床诊治提供参考。方法收集2010年1月到2017年1月24例(24耳)妊娠期突发性聋患者(妊娠组)的临床资料,对所有患者的年龄、耳侧、病程、双耳发病比例、孕周期、初诊听阈、耳鸣和眩晕及耳闷胀感伴发率、听力曲线类型、治疗效果进行统计分析,并与同期72例(76耳)孕龄期非妊娠女性突聋患者(非妊娠组)进行对比。妊娠组患者均给予低分子右旋糖酐-40治疗,其中13例给予鼓室注射地塞米松治疗。结果 24例妊娠期突聋患者均为单侧发病,4例(16.67%,4/24)发病于妊娠早期,9例(37.50%,9/24)发病于妊娠中期,11例(45.83%,11/24)发病于妊娠晚期;妊娠组患者病程(4.83±3.83天)短于非妊娠组(11.20±14.50天),差异有统计学意义(P<0.05);妊娠组初诊平均听阈(71.83±21.10 dB HL)及全聋型比例(58.33%)均高于非妊娠组(分别为60.52±23.97 dB HL,32.89%),差异有统计学意义(P<0.05);妊娠组治疗及随访期间未见明显不良反应,治疗后妊娠组总有效率为75.00%,痊愈率为33.33%,均高于非妊娠组(分别为50.00%和13.16%),差异有统计学意义(P<0.05);妊娠组中鼓室注射的患者总有效率(84.62%)高于未行鼓室注射的患者(63.64%),但差异无统计学意义(P>0.05)。结论妊娠期突发性聋常发病于妊娠中晚期,一旦发病听力损失往往较重,听力曲线以全聋型为主,低分子右旋糖酐-40静脉滴注疗效显著,联合鼓室注射激素的疗效有待进一步验证。

关键词

妊娠;突发性聋;鼓室注射;低分子右旋糖酐

基金项目(Foundation):

作者

石大志;肖娟;杨丽;罗志强;

参考文献

1 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.突发性聋诊断和治疗指南[J].中华耳鼻咽喉头颈外科杂志,2015,50:443.

2 侯志强,王秋菊.不同年龄段突聋患者的临床特点及预后研究进展[J]. 听力学及言语疾病杂志,2013,21:418.

3 Yen TT, Lin CH, Shiao JY, et al. Pregnancy is not a risk factor for idiopathic sudden sensorineural hearing loss: a nationwide population-based study[J]. Acta Otolaryngol,2016,136:446.

4 Sharma K, Sharma S, Chander D. Evaluation of audio-rhinological changes during pregnancy[J]. Indian J Otolaryngol Head Neck Surg, 2011,63:74.

5 Pawlak-Osinska K, Burduk PK, Kopczynski A. Episodes of repeated sudden deafness following pregnancies[J]. Am J Obstet Gynecol, 2009,200:e7.

6 Stenberg AE, Wang H, Fish J, et al. Estrogen receptors in the normal adult and developing human inner ear and in Turner’s syndrome[J]. Hear Res, 2001,157:87.

7 Lavy JA. Sudden onset deafness: two cases associated with pregnancy[J]. Int J Clin Pract, 1998,52:129.

8 Wiles NM, Hunt BJ, Callanan V. et al. Sudden sensorineural hearing loss and antiphospholipid syndrome[J]. Haematologica, 2006,91:124.

9 Goh AY, Hussain SS. Sudden hearing loss and pregnancy: a review[J]. J Laryngol Otol, 2012,126:337.

10 曾祥丽,何建成,李鹏,等.妊娠期突发性感音神经性聋21例报道[J].中华耳科学杂志,2014,12:207.

11 Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus[J]. Am J Clin Nutr, 2000,71:1256S.

12 何慧,张世科,刘勇,等.电项针加电耳周针治疗妊娠期突发性聋22例[J].中华耳科学杂志,2018,16:107.

13 Wang YP, Young YH. Experience in the treatment of sudden deafness during pregnancy[J].Acta Otolaryngol, 2006,126:271.

14 Qiang Q, Wu X, Yang T, et al. A comparison between systemic and intratympanic steroid therapies as initial therapy for idiopathic sudden sensorineural hearing loss: a meta-analysis[J]. Acta Otolaryngol, 2017,137:598.

15 Chen Y, Wen L, Hu P, et al. Endoscopic intratympanic methylprednisolone injection for treatment of refractory sudden sensorineural hearing loss and one case in pregnancy[J]. J Otolaryngol Head Neck Surg, 2010,39:640.

16 Chung JH, Cho SH, Jeong JH, et al. Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss in children[J]. Laryngoscope, 2015,125:2209.

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