不同高频听阈对疑似职业性噪声聋诊断结果的影响

Study of the impact diagnosis on suspected occupational noise-induced deafness after bring into the different high frequency hearing threshold weighted value

目的探讨在疑似职业性噪声聋诊断中应用不同高频听阈加权值的影响。方法针对清远市职业病防治院体检中心在2016年1月至2018年1月期间接诊的进行噪声作业的工人进行回顾性调查,根据《职业性噪声聋诊断标准》(GBZ 49-2007),对不同高频听阈加权值进行研究,首先进行诊断分级。根据年龄、性别、接害工龄等维度,予以对比分析,并研究其差异性。结果相比单纯语频,应用不同高频听阈加权值时,能得到更高的诊断率,加权3 k Hz提高了大约16.35%(χ^(2)=31.13,P<0.01)、4 k Hz增加了30.15%(χ^(2)=128.00,P<0.01)、6 k Hz增加了20.17%(χ^(2)=49.52,P<0.01)、(3+4)k Hz增加了22.29%(χ^(2)=62.16,P<0.01)、(3+6)k Hz增加了17.20%(χ^(2)=34.77,P<0.01)、(4+6)k Hz增加了25.26%(χ^(2)=83.20,P<0.01)、(3+4+6)k Hz增加了22.29%(χ^(2)=62.16,P<0.01),上述差异均有统计学意义;不同纳入标准的疑似职业性噪声聋诊断率在轻度(χ^(2)=205.77,P<0.01)、中度(χ^(2)=90.31,P<0.01)、重度(χ^(2)=29.82,P<0.01)比较中,差异均有统计学意义。结论在诊断疑似职业性噪声聋时,应用不同高频听阈能够有效提高诊断率,高频影响最高的是加权4 k Hz,诊断率提升较明显的还有加权(4+6)k Hz高频以及(3+4+6)k Hz高频。

Objective To explore the influence of different high frequency threshold weighting values in the diagnosis of suspected occupational noise deafness.Methods A retrospective survey was conducted on the workers exposed to noise in the physical examination center of Qingyuan occupational disease prevention and control hospital from January 2016 to Janu-ary 2018 In this paper,it was compared and analyzed the weighted values of different high-frequency hearing thresholds ac-cording to the dimensions of age,gender and length of service.Results Compared with pure speech frequency,the appli-cation of different high-frequency threshold weighted values can get higher diagnostic rate,weighted 3kHz increased by a-bout 16.35%(χ^(2)=31.13,P<0.01),4 k Hz increased by 30.15%(χ^(2)=128.00,P<0.01),6KHz increased by 20.17%(χ^(2)=49.52,P<0.01),3 k Hz+4 k Hz increased by 22.29%(χ^(2)=62.16,P<0.01),3 k Hz+6 k Hz increased by 17.20%(χ^(2)=34.77,P<0.01),4 k Hz+6 Hz increased by 22.29%(χ^(2)=62.16,P<0.01)26%(χ^(2)=83.20,P<0.01),3 k Hz+4 k Hz+6 k Hz increased by 22.29%(χ^(2)=62.16,P<0.01),The differences were statistically significant;the diagnostic rate of suspected occupational noise deafness in mild(χ^(2)=205.77,P<0.01),moderate(χ^(2)=90.31,P<0.01)and severe(χ^(2)=29.82,P<0.01)were statistically significant,among which the diagnostic rate of 4 k Hz high frequency weighted val-ue was the highest,followed by 4 k Hz+6 k Hz high frequency weighted value.Conclusion In the diagnosis of suspected occupational noise deafness,the application of different high frequency thresholds can effectively improve the diagnosis rate.The highest influence of high frequency is weighted 4 KHz,and the higher the diagnosis rate is weighted 4 k+6 k Hz and 3 k+4 k+6 k Hz.