应用纯音测听诊断职业性噪声聋的可靠性和有效性

PURE TONE AUDIOMETRY AS A RELIABLE AND EFFECTIVE PROCEDURE IN EVALUATION OF THE OCCUPATIONAL NOISE INDUCED HEARING LOSS

对6年以上工龄的青年织布女工108人(216耳)连续二次纯音测听的资料表明:第一次和第二次的听阈均值差除个别频率(8KHz左耳为3.5dB)外,其余各频率都在-0.3～0.5dB范围内;最大标准差于2KHz处为17.4dB,在3KHz和8KHz处分别为18.5dB、20.1dB。据此认为一次纯音测听的记录可作为职业性噪声聋诊断和评价听力损失程度的初步依据,必要时可用阻抗计测试镫骨肌反射阈和听觉脑干诱发反应测听以排除中耳疾患和非器质性聋。2例女工脱离噪声环境疗养2周,每隔一周复查听力一次,结果三次测听的语频均值出现21.7和13.3dB的差值,考虑系暂时性阈移的恢复。作者们对1980年卫生部门颁发的“噪声性聋调查方法”提出了改进意见。

It is shown that the pure tone audiometry used alone may be the basic method to evaluate occupational noise-induced hearing loss according to the data obtained from 108 female weavers (216 ears) exposed to weaving noise for 6 years or more. They were tested twice with the standard audiometric measurement without interval. Among them, some cases were confirmed by the determinations of acoustic reflex threshold of stapes muscle and auditory brain stem evoked response for excluding the diseases of middle ear and non-organic deafness, the range of difference between the first and second pure tone threshold average(PTA)was -0.3 to 1.5dB except 3.5dB at 8KHz of left ear. Their maximal standard deviations were 17.4 dB at 2 KHz and respectively 18.5, 20.1 at 3 and 8 KHz. Two weavers took rest for two weeks in a quiet sanatorium without noise exposure and had hearing measurements repeatedly carried out at intervals of 7 days. The difference of their PTA at speech frequencies were 21.7 dB and 13.3 dB. Such differences ought to be a result of recovery of temporary threshold shift. A suggestion to improve the regulation of the audiometry of the ducument published in 1980 by the Ministry of Health was offered.