短时急性噪声致听力下降和耳鸣的特征及药物治疗效果分析

Analysis of Characteristics of Hearing Loss and Tinnitus Induced by Short Time Acute Noise and the Efficacy of Drug Treatment

目的 分析短时急性噪声导致听力下降和耳鸣的临床特征,并评估药物治疗的效果。方法 对参加10发子弹步枪射击的222例空军军医大学新入学学员,在打靶前后进行纯音听阈检测和耳鸣评价量表评估,比较0.5、1、2、4和8 kHz的听阈变化;打靶后1 d出现听力下降且平均听阈大于25 dB HL的患者,口服泼尼松和金纳多治疗,耳鸣患者口服金纳多治疗。结果 打靶后1 d共33例(35耳)出现听力损失,占总例数的14.86%,其中7例(7耳)平均听阈大于25 dB HL;听力下降以4和8 kHz为主,且左耳4、8 kHz的听阈值明显高于右耳(P<0.05)。71例(97耳)出现耳鸣,占总例数的31.98%,其中65例为耳鸣Ⅰ级,6例为耳鸣Ⅱ级。平均听阈小于25 dB HL的患者打靶后14 d听力自然恢复正常。耳鸣患者以及平均听阈大于25 dB HL的患者经药物治疗,在打靶后14至30 d内听力恢复正常,耳鸣症状消失。结论 短时步枪射击可导致暂时性听力下降和耳鸣,早期进行药物治疗可促进听力恢复并改善耳鸣症状。

Objective To study the clinical characteristics of hearing loss and tinnitus caused by short time acute noise,and to evaluate the efficacy of drug treatment.Methods A total of 222 cadets of Air Force Medical University who participated in 10-round rifle shooting were tested for pure tone threshold and tinnitus evaluation scale was recorded before and after target training.The changes of hearing threshold at 0.5,1,2,4 and 8 kHz were compared.Patients with hearing loss and average hearing threshold greater than 25 dB HL 1 day after target shooting were treated with oral prednisone acetate and ginaton,and all tinnitus patients were treated with oral ginaton.Results There were 33 trainees(35 ears)with hearing loss 1 day after the training,accounting for 14.86%of the total number of people,among which 7 trainees(7 ears)had an average hearing threshold greater than 25 dB HL.The hearing loss was mainly at 4 and 8 kHz,and hearing threshold in the left ear at 4 and 8 kHz was significantly higher than that in the right ear(P<0.05).There were 71 trainees(97 ears)with tinnitus,accounting for 31.98%of the total number of people.Among them,65 trainees had tinnitus with I grade,and 6 trainees were tinnitus with II grade.Patients with a mean hearing threshold of less than 25 dB HL naturally returned to normal hearing 14 days after the training.Patients with tinnitus and those with an average hearing threshold greater than 25 dB HL received drug treatment,and their hearing returned to normal within 14~30 days after the training,and tinnitus symptoms disappeared.Conclusion Short rifle shots can cause temporary hearing loss and tinnitus.Medical treatment at an early stage may promote hearing recovery and improve tinnitus symptoms.