行为测听在儿童主观听力评估中的应用  

Application of behavioral audiometry in subjective hearing assessment of children

作　　者：谌国会 丁海娜[1] 史伟[1] 谢林怡[1] 熊芬[1] 兰兰[1] 张娇[2] 王秋菊[2] CHEN Guohui;DING Haina;SHI Wei;XIE Linyi;XIONG Fen;LAN Lan;ZHANG Jiao;WANG Qiuju(Department of Otolaryngology Head and Neck Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing,100853,China;Department of Audiology and Vestibular Medicine,Institute of Otolaryngology,Senior Department of Otolaryngology Head and Neck Surgery,the Sixth Medical Center of Chinese PLA General Hospital,National Clinical Research Center for Otolaryngologic Diseases)

机构地区：[1]解放军总医院第一医学中心耳鼻咽喉头颈外科,北京100853 [2]解放军总医院第六医学中心耳鼻咽喉头颈外科医学部耳鼻咽喉内科、耳鼻咽喉研究所、国家耳鼻咽喉疾病临床医学研究中心

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第3期173-176,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金重点项目(No:81830028);国家自然科学基金优秀青年基金项目(No:82222016);国家自然科学基金面上项目(No:82271189、82271171、82171130);军队后勤科研计生专项(No:19JSZ14);解放军总医院医疗大数据分析及应用研究(No:2019MBD-005)联合资助。

摘　　要：目的:探究行为测听在儿童主观听力评估中的价值及影响因素。方法:回顾性分析2012年1月—2015年12月就诊的1944例(3888耳)儿童的行为测听(视觉强化或游戏测听)检查结果,将主观表现(“好”、“中等”、“差”、“未完成”)按年龄、听力水平进行分组比较,运用SPSS 27.0软件进行统计分析。结果:儿童主观表现“好”者2791耳(71.8%)、“中等”者411耳(10.6%)、“差”者309耳(7.9%)、“未完成”者377耳(9.7%)。在视觉强化测听中,儿童主观表现为“好”的比例随年龄增长逐步上升至2岁时达到高峰,2岁之后随年龄增长而下降;在游戏测听中,儿童主观表现为“好”的比例随着年龄增长逐步上升至4~5岁时达到高峰。“未完成”者主要为1~3岁儿童,原因为不合作148耳、哭闹95耳、拒戴耳机57耳、疲劳42耳、没兴趣20耳、不理解14耳、注意力分散1耳。结论:行为测听有助于评估儿童的主观听力,儿童主观表现整体较好。在临床工作中应结合低龄儿童的身心特点,采用或开发更加新颖而又有吸引力的测试材料及方法。Objective: To explore the value and influencing factors of behavioral audiometry in subjective hearing assessment of children. Methods: The results of behavioral audiometry(visual reinforcement audiometry or play audiometry) of 1944 children(3888 ears) in the outpatient department from January 2012 to December 2015 were retrospectively analyzed. The subjective performance( " good ", "moderate", "poor", " unfinished ") was compared according to age and hearing level. SPSS 27.0 software was used for statistical analysis. Results: The subjective performance of children was "good" in 2791 ears(71.8%), "moderate" in 411 ears(10.6%), "poor" in 309 ears(7.9%) and " unfinished " in 377 ears(9.7%). In visual reinforcement audiometry, the proportion of children who subjectively performed as "good" gradually increased with age, reaching the peak at 2 years old, and decreased with age after 2 years old. In play audiometry, the proportion of children who subjectively performed as "good" gradually increased with age, peaking at 4-5 years of age. The children who did not finish the test were mainly 1-3 years old. The reasons included uncooperation for 148 ears, crying for 95 ears, refusing to wear headphones for 57 ears, fatigue for 42 ears, lack of interest for 20 ears, not understanding for 14 ears, and distraction for 1 ear. Conclusion: Behavioral audiometry was helpful to assess children’s subjective hearing, and children’s subjective performance was good. In clinical work, more novel and attractive test materials and methods should be adopted or developed according to the physical and mental characteristics of young children.

关 键 词：儿童 行为测听 主观测听 

分 类 号：R764[医药卫生—耳鼻咽喉科]