Effect of hyperbaric oxygen therapy and corticosteroid therapy in military personnel with acute acoustic trauma
Effect of hyperbaric oxygen therapy and corticosteroid therapy in military personnel with acute acoustic trauma
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DOI：
10.1136/jramc-2018-001117
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发表时间：
2020-08-01
影响因子：
1.5
通讯作者：
de Ru, J. A.
中科院分区：
文献类型：
--
作者：
Bayoumy, A. B.;van der Veen, E. L.;de Ru, J. A.
急性声损伤（AAT）是一种由于暴露于强脉冲噪声导致耳蜗缺氧而引起的感音神经性听力损伤。高压氧治疗（HBO）可以提供充足的氧气供应。目的是研究与皮质类固醇单药治疗相比，AAT患者早期HBO联合皮质类固醇治疗的有效性。方法回顾性分析2012年11月至2017年12月我院收治的AAT患者的临床资料。HBO治疗的入选标准是与对侧耳相比，至少一个频率的听力损失为30 dB或以上，至少两个频率的听力损失为25 dB或以上，或三个或更多频率的听力损失为20 dB或以上。结果HBO组与对照组在500 Hz（p=0.014）、3000 Hz（p=0.023）、4000 Hz（p =0.001）和6000 Hz（p = 0.01）以及所有频率的平均值（p =0.002）下的绝对听力改善存在显著差异（独立t检验）。在4000 Hz（p=0.046）和6000 Hz（p=0.013）以及所有频率组合（p =0.005）下，相对听力改善显著不同（独立t检验）。此外，HBO组中恢复到荷兰武装部队所要求的功能水平（临床结局评分）的患者百分比较高。结论AAT患者的早期联合治疗与更高频率的听力测定结果和更好的临床结局评分相关。
Introduction Acute acoustic trauma (AAT) is a sensorineural hearing impairment due to exposure to an intense impulse noise which causes cochlear hypoxia. Hyperbaric oxygen therapy (HBO) could provide an adequate oxygen supply. The aim was to investigate the effectiveness of early treatment with combined HBO and corticosteroid therapy in patients with AAT compared with corticosteroid monotherapy. Methods A retrospective study was performed on military personnel diagnosed with AAT between November 2012 and December 2017. Inclusion criteria for HBO therapy were hearing loss of 30 dB or greater on at least one, 25 dB or more on at least two, or 20 dB or more on three or more frequencies as compared with the contralateral ear. Results Absolute hearing improvements showed significant differences (independent t-test) between patients receiving HBO and the control group at 500 Hz (p=0.014), 3000 Hz (p=0.023), 4000 Hz (p=0.001) and 6000 Hz (p=0.01) and at the mean of all frequencies (p=0.002). Relative hearing improvements were significantly different (independent t-test) at 4000 Hz (p=0.046) and 6000 Hz (p=0.013) and at all frequencies combined (p=0.005). Furthermore, the percentage of patients with recovery to the functional level required by the Dutch Armed Forces (clinical outcome score) was higher in the HBO group. Conclusions Early-stage combination therapy for patients with AAT was associated with better audiometric results at higher frequencies and better clinical outcome score.