摘要
目的:探讨双侧感音神经性耳聋患者的病因、实验室检查、影像学检查、治疗及预后,为临床诊治提供借鉴。方法:收集2014年1月至2019年1月龙岩市第二医院收治的15例双侧感音神经性耳聋患者的临床资料,对其病因、听力检查、实验室及影像学检查、治疗及预后进行回顾性分析。结果:15例双耳感音神经性耳聋患者中,耳科疾病3例(20%),其中1例为中耳炎导致肥厚性硬脑膜炎引起,2例为突发性耳聋。其他12例(80%)由系统性疾病引起。其中4例为颅内感染引起,颅内感染中病毒性脑膜炎2例、结核性脑膜炎1例、化脓性脑膜炎1例;均伴有明显发热、头痛等颅内感染表现,其中3例单耳起病后出现双耳耳聋,1例双耳起病,进行性加重;4例为免疫系统损伤引起,其中系统性红斑狼疮2例,类风湿关节炎1例,抗中性粒细胞胞浆抗体(ANCA)相关性血管炎1例;2例为糖尿病患者引起,其中1例进行性对称性下降;2例为耳毒性药物引起;15例患者经病因及对症治疗后痊愈2例,显效2例,治疗有效率为26.7%。结论:双耳感音神经性耳聋病因复杂,应首先考虑全身系统性疾病引起,临床上应仔细追问病史,完善实验室、影像学等相关检查明确病因,根据病因寻找最优治疗方案。
Objective To investigate the etiology,laboratory,examination,imaging examination,treatment and prognosis of patients with bilateral sensorineural hearing loss(bi-SNHL).Methods From January 2014 to January 2019,Clinical data of 15 cases of patients in Longyan second hospital with bi-SNHL were analyzed systematically,including etiology,hearing test,laboratory and imaging examination,treatment and prognosis.Results There were 3 otologic diseases in 15 patients,accounting for 20%of the total cases,1 case was caused by hypertrophic meningitis and it was caused by otitis media and 2 cases were sudden deafness.The other 12 cases(80%)were caused by systemic diseases.Among them,4 cases were caused by intracranial infection,2 cases were caused by viral meningitis,1 case was caused by tuberculous meningitis and 1 case was caused by purulent meningitis.Intracranial infections were accompanied by obvious fever,headache and other intracranial infections.Among them,3 cases had bilateral deafness after uniaural onset,and 1 case had bilateral onset with progressive aggravation.4 cases were caused by immune system injury,among them,2 cases were systemic lupus erythematosus,1 case was rheumatoid arthritis and 1 case was ANCA-associated vasculitis.2 cases were caused by diabetes mellitus,one of them progressively decreased symmetry.2 cases were caused by ototoxic drugs.After the treatment aimed at the causes,2 cases were cured,2 patients were markedly effective.The effective rate of treatment was 26.7%.Conclusion The etiology of bi-SNHL is complex.Systemic diseases should be considered first.Clinical history should be actively questioned,laboratory and imaging examinations should be improved to clarify the etiology,and the optimal treatment plan should be found according to the etiology.
作者
叶星星
赖建忠
邱金庆
YE Xing-xing;LAI Jian-zhong;QIU Jin-qing(Longyan Second Hospital,Fujian Longyan 364000)
出处
《深圳中西医结合杂志》
2019年第18期90-93,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
感音神经性耳聋
颅内感染
系统性疾病
Sensorineural hearing loss
Intracranial infection
Immune system
