职业性噪声聋诊断的临床路径管理模式探讨  

Discussion on Clinical Path Management Model of Occupational Noise-induced Deafness Diagnosis

作　　者：陈国顺 张焕玲 刘瑞贞 谷桂珍 余善法 CHEN Guoshun;ZHANG Huanling;LIU Ruizhen;GU Guizhen;YU Shanfa(Wugang Institute of Occupational Disease Prevention and Control,Wugang Henan 462500,China;General Hospital of Wugang Company,Wugang Henan 462500,China;Henan Institute of Occupational Disease Prevention and Control,Zhengzhou Henan 450052,China;Henan Medical College,Zhengzhou Henan 451191,China)

机构地区：[1]舞钢劳动卫生职业病防治研究所,河南舞钢462500 [2]舞钢公司总医院,河南舞钢462500 [3]河南省职业病防治研究院,郑州450052 [4]河南医学高等专科学校,郑州451191

出　　处：《河南医学高等专科学校学报》2019年第5期639-644,共6页Journal of Henan Medical College

基　　金：国家自然科学基金面上项目(81372940,81872574);国家科技支撑计划课题(2014BAI12B03)

摘　　要：目的探讨职业性噪声聋诊断的临床路径管理模式。方法本文结合工作实践,遵循循证医学证据,回顾我国职业病诊断管理法规、职业性噪声聋诊断标准的变迁,分析职业病诊断机构在职业性噪声聋诊断工作中纯音测听等关键诊断依据同质化、可比性、溯源性较差的影响因素。结果对正确使用职业性噪声聋诊断标准和临床路径管理的关键要素进行了说明,探讨采取适宜的职业性噪声聋临床路径管理模式诊断治疗疑似噪声聋患者的准确性、可靠性、可比性和溯源性。结论提出的职业性噪声聋临床路径和职业性噪声聋临床路径表单,有助于完善和提高职业性噪声聋诊断的规范性、科学性。Objective To explore clinical path management model of occupational noise-induced deafness diagnosis.Methods Following evidence-based medical evidence,combining with the working practice,on the basis of reviewing the changes of regulations on the management of occupational disease diagnosis and the diagnostic criteria of occupational noise-induced deafness in China,analyzing the factors influencing the homogenization,comparability and poor traceability of key diagnostic bases such as pure tone audiometry in the diagnosis of occupational noise-induced deafness by occupational disease diagnostic institutions.Results The authors explain the key elements of the correct use of diagnostic criteria of occupational noise-induced deafness and clinical path management and take appropriate clinical pathway management model of occupational noise-induced deafness to diagnose and treat patients with suspected noise-induced deafness,so as to ensure the accuracy,reliability,comparability and traceability of the diagnosis results of occupational noise-induced deafness.Conclusion The recommended clinical pathway and its form of occupational noise-induced deafness can improve the standardization and scientific alness of the diagnosis of occupational noise-induced deafness.

关 键 词：职业性噪声聋诊断 噪声作业人员 临床路径 管理模式 

分 类 号：R135.8[医药卫生—劳动卫生]