基于GBZ 49-2007与GBZ 49-2014职业性噪声性聋诊断标准的临床实践对比分析  

Comparative analysis of clinical practice based on GBZ 49-2007 and GBZ 49-2014 diagnostic criteria for noise induced hearing loss

作　　者：周彩玲[1] 李勇[2] 胡祖应[1] 朱赛群[1] ZHOU Cailing;LI Yong;HU Zuying;ZHU Saiqun(Department of Occupational Medicine,Hangzhou Occupational Disease Prevention and Treatment Center,Hangzhou,Zhejiang,310014,China;Department of Otolaryngology,Hangzhou First People’s Hospital,Hangzhou,Zhejiang,310006,China)

机构地区：[1]杭州市职业病防治院职业病科,浙江杭州310014 [2]杭州市第一人民医院耳鼻咽喉科,浙江杭州310006

出　　处：《中国耳鼻咽喉头颈外科》2024年第10期635-638,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨基于GBZ 49-2007和GBZ 49-2014职业性噪声性聋诊断标准的临床实践差异。方法选取2016年1月~2023年11月在杭州市职业病防治院申请职业性噪声性聋诊断的265例噪声劳动者。依据GBZ 49-2007与GBZ 49-2014噪声性聋诊断标准进行诊断。结果(1)依据GBZ 49-2014标准职业性噪声性聋诊断率为43.77%,明显高于依据GBZ 49-2007标准的27.55%(P<0.05);(2)依据GBZ 49-2014标准与依据GBZ 49-2007标准职业性噪声性聋诊断一致性κ值为0.656,诊断一致性较好(P<0.05),诊断一致率为82.64%;(3)工龄≥10年接噪工作者依据GBZ 49-2007和GBZ 49-2014职业性噪声性聋诊断率分别为38.10%和53.33%,相比工龄<10年接噪工作者的20.63%和37.50%高(P<0.05)。结论相比较GBZ 49-2007标准,依据GBZ 49-2014标准会使职业性噪声性聋诊断率提高;无论是依据GBZ 49-2007还是GBZ 49-2014标准下,职业性噪声性聋诊断率及严重程度都与工龄有关。OBJECTIVE To explore the clinical practice differences based on GBZ 49-2007 and GBZ 49-2014 diagnostic criteria for occupational noise induced hearing loss.METHODS Two hundred and sixty-five noise workers who applied for occupational noise induced hearing loss diagnosis in Hangzhou Occupational Disease Prevention and Treatment Center from January 2016 to November 2023 were selected and diagnosed according to the diagnostic criteria of GBZ 49-2007 and GBZ 49-2014 for noise induced hearing loss.RESULTS The diagnostic rate of occupational noise induced hearing loss in GBZ 49-2014 standard was 53.58%,which was significantly higher than the 42.64%in GBZ 49-2007 standard(P<0.05).Theκvalue of the diagnostic consistency between the GBZ 49-2014 standard and the GBZ 49-2007 standard for occupational noise induced hearing loss was 0.761,P<0.05,indicating good diagnostic consistency with a diagnostic consistency rate was 86.04%.The diagnostic rate of occupational noise induced hearing loss(GBZ 49-2007)among workers with work experience≥10 years was 59.05%,which was higher than that of workers with work experience<10 years(P<0.05).The diagnostic rate of occupational noise induced deafness in workers with work experience≥10 years(GBZ 49-2014)was 72.38%,which is higher than that of workers with work experience<10 years(P<0.05).According to the diagnosis of occupational noise induced hearing loss in GBZ 49-2007 and GBZ 49-2014,patients with work experience≥10 years had a higher severity of occupational noise induced hearing loss than those with work experience<10 years(P<0.05).CONCLUSION Compared to the GBZ 49-2007 standard,the GBZ 49-2014 standard will increase the diagnostic cases of occupational noise induced hearing loss;Under the GBZ 49-2007 and GBZ 49-2014 standards,the diagnosis and severity of occupational noise induced hearing loss are related to length of service.

关 键 词：噪声 职业性 听觉丧失 噪声性 GBZ 49-2007 GBZ 49-2014 

分 类 号：R764.433[医药卫生—耳鼻咽喉科]