听力测试组合在鉴别诊断煤矿工人噪声性耳聋患者伪聋和夸大性聋中的应用  

Application of hearing test in the differential diagnosis of false deafness and exaggerated deafness in coal mine workers with noise-induced deafness

作　　者：徐孝玲 文永霞 魏健 XU Xiaoling;WEN Yongxia;WEI Jian(Department of Otolaryngology,The Third People's Hospital of Ningxia,Yinchuan 750004,China)

机构地区：[1]宁夏第三人民医院耳鼻喉科,宁夏银川750011

出　　处：《宁夏医学杂志》2019年第1期15-17,共3页Ningxia Medical Journal

摘　　要：目的探讨听力测试组合在鉴别诊断煤矿工人噪声性耳聋患者伪聋和夸大性聋中的应用价值。方法对某煤矿工作超过1年的1 960例工人(办公区工人260人、井上工人239人、井下工人1 461人;工龄1～5年1 034人、5～10年550人、>10年376人),采用主观和客观联合测试方法进行听力测试。主观方法为PTA测试,客观方法主要为听性脑干反应(ABR)和畸变产物耳声发射(DPOAE)检测,记录PTA检测和联合客观检测结果,比较不同工龄煤矿工人听力下降及下降程度。结果 PTA检测听力下降743例(办公区工人8人、井上工人14人、井下工人721人)。743例中367人配合,376人不配合;工龄1～5年对象听力下降比例为24.8%、5～10年为40.7%、>10年为69.9%(P>0.05),高频损失分级在不同工龄间差异无统计学意义(P>0.05);DPOAE检测:不配合376人,其中272人为伪聋(72.3%),104人为扩大性听力下降(27.9%);ABR检测:376人进行检测显示,272人耳平均阈值为(19.89±3.42) d BHL,104人为(42.45±6.67) d BHL。结论主客观听力测试方法联合检测可以客观、准确地鉴别诊断伪聋和夸大性聋,值得推荐。Objective To investigate the application of hearing test combination in the differential diagnosis of noise-induced deafness in mine workers.Methods A total of 1 960 workers who worked in a coal mine for more than one year were collected,including260 workers in the office area,239 mine workers in the mine area and 1461 miners in the mine area,of whose working years was one to five years in 1034 workers,5~10 years in 550 workers,and>10 years in 376 workers.The workers were used the subjective and objective joint test methods for hearing test.The subjective method was PTA test.The objective methods were mainly the auditory brainstem response(ABR)and the distortion products otoacoustic sounding(DPOAE)test,recording PTA test and combined with objective test results,comparing different age mine workers hearing loss and loss.Results 743 cases of hearing loss were detected by PTA(8 workers in the office area,14 mine workers in the mine and 721 miners in the mine).367 of 743 cases were matched with 409 ears,with a ratio of 49.4% and 376 ears(499 ears);hearing loss was 24.8% in 1~5 years,40.7% in 5~10 years and 69.9% in 10 years(P>0.05).There was significant difference in the frequency of high-frequency loss between different years of service(P>0.05).DPOAE did not match 376(499 ears),of which 272(360 ears)72.3%,105(139 ears)were enlarging deafness,the proportion was27.9%;ABR test:376 people(499 ears)showed that the average threshold value of ears of 272 people(360 ears)was(19.89 ± 3.42)d BHL;(139 ears)was(42.45 ± 6.67)d BHL,and the test results and DPOAE test was consistent.Conclusion The combination of subjective and objective hearing tests can be objective and accurate differential diagnosis of false ears and exaggerated deafness,and it is recommended.

关 键 词：听力测试 煤矿工人 噪声性耳聋 伪聋 夸大性聋 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]