中国实用神经疾病杂志2025，Vol.28Issue(9)：1147-1152,6.DOI:10.12083/SYSJ.250630
神经性耳聋诊疗现状与预后的影响因素分析
Analysis of the current situation of diagnosis and treatment of nerve deafness and influencing factors of prognosis
摘要
Abstract
Objective To analyze the current diagnosis and treatment status of nerve deafness,as well as the distribution of causes and differences in therapeutic effects among patients with nerve deafness,and evaluate the influencing factors for the prognosis.Methods This study is a prospective randomized controlled trial.Totally 160 patients diagnosed with nerve deafness at Liu'an Hospital of Traditional Chinese Medicine from January 2023 to January 2025 were selected.The patients were randomly divided into two groups using computer-generated random number table.The observation group received a triple intervention plan of"glucocorticoids+hyperbaric oxygen therapy+vestibular rehabilitation training",while the control group received monotherapy with glucocorticoids.Pure tone audiometry threshold,quality of life(SF-36 score),dizziness control(DHI score),recurrence rate,and glucocorticoid related adverse reactions(such as elevated blood glucose and osteoporosis)between the two groups were collected.Cox proportional hazards model was used to analyze the influencing factors of prognosis.Results The comparison of therapeutic effects between the two groups showed that the observation group had significantly lower pure tone audiometry thresholds,SF-36 scale scores,and DHI scale scores in all dimensions compared to the control group(P<0.05).The prognosis comparison between the two groups showed that the recurrence rate in the observation group was significantly lower than that in the control group(P<0.05).The safety comparison between the two groups showed that the observation group had significantly lower rates of blood glucose elevation and osteoporosis compared to the control group(P<0.05).Cox proportional hazards model analysis showed that older age(OR=14.275,95%CI:4.017-30.294),longer duration of dizziness(OR=9.758,95%CI:2.373-16.624),higher degree of hearing loss(OR=11.160,95%CI:3.784-26.364),delayed treatment timing(OR=8.825,95%CI:2.846-29.163),and single treatment plan(OR=19.167,95%CI:2.868-89.764)were risk factors for poor prognosis in patients with nerve deafness(P<0.05).Conclusion The diagnosis and treatment of nerve deafness should comprehensively consider factors,such as the degree of hearing loss,duration of dizziness,accompanying symptoms,and onset time.Early diagnosis and intervention are keys to improving prognosis,and the combination of glucocorticoids and microcirculation improving drugs is the main treatment option.In the future,further exploration of the etiology mechanism,optimization of treatment plans,and establishment of a precise prognostic evaluation system are needed to improve the treatment efficacy and quality of life.关键词
神经性耳聋/眩晕/诊疗现状/预后评估/糖皮质激素/微循环Key words
Nerve deafness/Dizziness/Current diagnosis and treatment status/Prognostic assessment/Corticosteroids/Microcirculation分类
医药卫生引用本文复制引用
孙梦黎,文继祥,邓娴,李建委,丁美钱..神经性耳聋诊疗现状与预后的影响因素分析[J].中国实用神经疾病杂志,2025,28(9):1147-1152,6.基金项目
六安市科技计划项目(编号:2023LCTH276) （编号:2023LCTH276）
