摘要
目的:分析爆震性耳聋的听力改变及相关因素。方法:对第三军医大学大坪医院野战外科研究所耳鼻咽喉-头颈外科1998-07/2003-07住院的爆震性聋患者21例(42耳)行纯音测听及声阻抗测定,作定期的听力追踪测试。并给予高压氧、药物和手术等方法治疗。对临床资料进行回顾性分析。按照疗效判定标准进行分析:鼓膜穿孔愈合,听力达实用水平(各频率听阈25dBHL以内),无耳鸣、头痛头昏、眩晕等症状为治愈;鼓膜穿孔愈合,听力明显提高,但听阈>25dBHL,耳鸣、头痛头昏、眩晕等症状明显缓解为显效;鼓膜穿孔愈合,听力提高15dBHL,耳鸣、头痛头昏、眩晕等症状减轻为有效;鼓膜穿孔未愈,听力提高不足15dBHL或无变化,耳鸣、头痛头昏、眩晕等症状无变化或加重为无效。结果:按实际处理分析,进入结果分析患者21例。①感音神经性及混合性耳聋分别占34%(14/42)和33%(14/42);听力曲线以水平下降、斜坡下降和陡坡下降为主;鼓室功能曲线“A”型占多数达57%(24/42);蹬骨肌反射同侧刺激引出同侧占57%(24/42),对侧刺激引出同侧占43%(18/42)。②在爆震后第9天测得最差听阈,第20天听阈略有恢复。③21例(42耳)治疗后听力恢复正常17例(34耳),显效2例(4耳),无效2例(4耳),总有效率为90%(38/42);9例(14耳)鼓膜穿孔全部愈合。结论:爆震性聋听力恢复速度早期较快,逐渐变慢,早期听力损害严重者恢复不良。爆炸冲击波和脉冲波对内耳损伤严重,呈不可逆改变;对中耳结构影响相对较小。
AIM： To analyze the heating changes after explosive deafness and discuss the correlative factors. METHODS： Audiometry of pure voice, acoustic impedance and periodic hearing tracing test were conducted in 21 patients with explosive deafness （42 ears） in the Department of Otolaryngology-Neck of Daping Hospital of Third Military Medical University from July 1998 to July 2003. They were treated with hyperbaric oxygen, drugs and andertaken operation. A retrospective analysis of clinical date was conducted according to the evaluative criteria. The evaluative criteria for curative effect were as follows： Healing as healed perforation of ear drum. hearing recovered to the utility level （auditory threshold of all the frequencies no more than 25 dBHL）, no tinnltus, headache, dizzy and vertigo： Remarkable efficiency as healed perforation of ear drum, obvious improvement in heating, auditory threshold more than 25 dBHL remarkable remission of tinnitus, headache, dizzy and vertigo; Efficiency as healed peril）ration of ear drum, improvement in heating （auditory threshold inereased by 15 dBHL）, alleviation of tinnitus, headache, dizzy and vertigao： Inefficiency as non-healed perforation of ear drum, auditory threshold increased no more than 15 dBHL or no changes in auditory threshold, no changes or aggravation in tinnitus, headache, dizzy and vertigo. RESULTS： According to the actual management, 21 cases were all involved in the result analysis. ① In 21 cases of explosive deafness, neurosensory deafness and mixed deafness accounted for 34%（14/42） and 33%（14/42）, respectively. The audio-curves of the patients showed the decreasing of the level, the incline and the abrupt slope. The curves of tympanum function were mainly type A up to 57%（24/42）. That the same side stimulating in stapedius reflection caused the same side one was 57% （24/42）, and that the opposite side stimulating caused the same side one was 43%（18/42）. ②The hearing threshold was greatly serious at day 9 after bla
出处
《中国临床康复》
CSCD
北大核心
2005年第34期96-98,共3页
Chinese Journal of Clinical Rehabilitation
