听力检测3种方法联合评价职业性噪声聋的效果

Assessment of Occupational Noise-induced Hearing Loss with Three Methods

目的探讨3种听力检测方法联合应用在职业性噪声聋的诊断过程中的作用。方法2007年11月—2008年11月来深圳市职业病防治院住院申请职业性噪声聋诊断患者共28例,每例患者均行3次纯音听阈测听,2次检测之间间隔3d以上,同时检测听性脑干反应、听性稳态反应1次。综合分析上述检测结果进行职业性噪声聋诊断。结果28例申请职业性噪声聋诊断病例中,经3种方法联合评价后,8例诊断为职业性轻度噪声聋,1例诊断为职业性中度噪声聋,2例诊断为职业性重度噪声聋;17例不能诊断为职业性噪声聋病例中,5例诊断为观察对象,1例诊断为伪聋,3例诊断为夸大聋,剩下9例为其他原因致聋。若单纯使用纯音听阈测试结果评价,至少还有4例可被诊断为不同程度职业性噪声聋。结论3种方法联合评价职业性噪声聋可明显提高职业性噪声聋的诊断准确性,有效排除伪聋及夸大聋。

[ Objective] To explore the effect of 3 hearing detection methods combination on diagnosis of noise-induced heating loss. [ Methods] A total of 28 patients applied for the diagnosis of occupational noise-induced hearing loss in Shenzhen Occupational Disease Prevention Hospital during December 2007m December 2008. All took 3 times of pure tone audiometry （ PTA ） every three or more days, and 1 time of auditory brainstem response （ABR） and auditory steady-state response （ASSR }. [ Results ] Among 28 cases, assessed with 3 methods combination, only 8 were diagnosed lightly occupational noise-induced hearing loss j I was moderately occupational noise-induced hearing loss, 2 were severe occupational noise-induced hearing loss ; among 17 cases of undiagnosed occupational noise-induced hearing loss, 5 were diagnosed as objects of observation, 1 was pseudo-deaf, 3 were exaggerated heating loss, the rest 9 were other reasons-induced hearing loss. If only using pure-tone heating threshold evaluation results, at least 4 cases would have been diagnosed as occupational noise deafness of different levels. [ Conclusion] Three heating detection methods combination can obviously raise the diagnostic accuracy of noise-induced heating loss, and effectively exclude pseudo-deaf and exaggerated heating loss.