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高压氧气治疗启动延迟对急性声学创伤后的听觉结果的影响
Maayan Manheim1, Liel Mogilevsky1, Amit Geva1
1Israel Naval Medical Institute, Israel Defence Force Medical Corps, Haifa, Israel.
Diving and hyperbaric medicine
|June 21, 2025
概括
早期的高压氧 (HBO) 治疗可以改善声学创伤后的听力恢复. 在七天内治疗显著增加了积极的结果,响应率在三周后下降.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 紧急医疗 紧急医疗
- 航空航天医学 航空航天医学
背景情况:
- 由于暴露于强烈噪音的急性声学创伤可能导致严重的听力损失.
- 高压氧气 (HBO) 治疗正在作为一种辅助治疗来改善听力结果.
- 在声学创伤后启动HBO治疗的最佳时间尚不清楚.
研究的目的:
- 确定早期高压氧疗法 (HBO) 在急性声学创伤后改善听力方面的疗效.
- 建立HBO治疗启动的最佳时间框架,以最大限度地恢复听力.
主要方法:
- 患有急性声学创伤的患者接受了联合HBO和皮质类固醇治疗.
- 治疗包括80分钟253kPa的HBO,治疗数量根据反应进行调整.
- 主要结果:在高纯音频 (3-8 kHz) 中至少有10dB的改善. 二次结果包括高纯色总和 (HPTS) 变化和恢复战斗准备.
主要成果:
- 在七天内接受治疗的患者中,88%的患者实现了主要结局,而21+天后接受治疗的患者中,这一比例为56% (P = 0.002).
- 早期治疗 (7天内) 显示HPTS显著改善 (55dB对-5dB),HPTS相对改善 (55%对3%),并恢复战备状态 (57%对15%).
- 这些发现在调整年龄,初始听力损失和损伤机制后仍然存在.
结论:
- 早期启动高压氧 (HBO) 治疗对于改善急性声学创伤的治疗反应至关重要.
- 对于HBO来说,最佳的治疗延迟时间似乎是在受伤后的七天内.
- 延迟超过三周的HBO治疗与有效性显著降低有关.
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