爆震性听力损失临床特征及疗效分析  

Clinical characteristics and therapeutic effect analysis of blast-induced hearing loss

作　　者：曹扬 吴萧男 李进 王洪阳 王秋菊 CAO Yang;WU Xiaonan;LI Jin;WANG Hongyang;WANG Qiuju(Department of Audiology and Vestibular Medicine,Senior Department of Otolaryngology Head and Neck Surgery,the Sixth Medical Center of Chinese PLA General Hospital,Beijing,100853,China;National Clinical Research Center for Otolaryngologic Diseases,Chinese PLA Medical School)

机构地区：[1]中国人民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,北京100853 [2]国家耳鼻咽喉疾病临床医学研究中心解放军医学院

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第3期228-232,238,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家重点研发计划(No:2023YFC2508400,2023YFC2509800,2023YFF1203504);国家自然科学基金(No:82171130,82222016,82350005)。

摘　　要：目的:探讨爆震性听力损失(blast-induced hearing loss,BIHL)患者的临床特征及治疗效果。方法:统计分析耳内科病房收治的爆震接触后突发听力下降患者与特发性突聋(idiopathic sudden hearing loss,ISHL)患者的临床特征、检验指标、听力水平、疗效。组间比较使用独立样本t检验、Wilcoxon秩和检验、χ^②检验,以P<0.05为差异有统计学意义。结果:共纳入59例爆震组(BIHL)患者与117例对照组(ISHL)患者。BIHL组平均年龄(39.07±14.49)岁;男45例,女14例;爆震后14 d内入院患者21例,超过14 d入院患者38例;单侧发病33例,PTA为(50.30±28.85)dB HL,双侧发病26例,PTA为(44.54±26.22)dB HL。ISHL组单侧发病112例,PTA为(56.28±14.19)dB HL,双侧发病5例,PTA为(56.25±35.14)dB HL。BIHL组14 d内入院治疗有效率31.8%,ISHL组14 d内有效率77.0%。结论:BIHL由高强度噪声暴露导致,住院治疗总有效率低于ISHL,且治疗时间窗更短,因此应更加注重预防。Objective To investigate the clinical characteristics and treatment outcomes of patients with blast-induced hearing loss(BIHL).Methods The clinical features,laboratory parameters,audiometric profiles,and treatment efficacy of patients with blast induced hearing loss and those with idiopathic sudden hearing loss(ISHL)were analyzed using t-tests,Wilcoxon rank-sum tests,and chi-square tests,with a significance level set at P<0.05.Results A total of 59 patients in the BIHL group and 117 patients in the ISHL group were included in this study.The mean age of the BIHL group was(39.07±14.49)years,comprising 45 males and 14 females.After the blast,21 patients went to the hospital within the initial 14-day period,and an additional 38 patients seeking admission thereafter.In the BIHL group,33 patients had unilateral hearing loss with PTA of(50.30±28.85)dB HL,while 26 had bilateral hearing loss with a PTA of(44.54±26.22)dB HL.In comparison,among the ISHL group,112 patients had unilateral hearing loss with a PTA of(56.28±14.19)dB HL,and 5 had bilateral involvement with a PTA of(56.25±35.14)dB HL.The effective treatment rate within 14 days for the BIHL group was 31.8%,while for the ISHL group,the effective rate within 14 days was 77.0%.Conclusion Blast-induced hearing loss is caused by exposure to high-intensity noise.The overall treatment effectiveness during hospitalization is lower compared to idiopathic sudden hearing loss,and the treatment window is shorter.Therefore,greater emphasis should be placed on prevention.

关 键 词：爆震性听力损失 突发性聋 临床特征 疗效 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]