急性噪声损伤后耳鸣患者的临床特征分析

Clinical Characteristics of Tinnitus after Acute Noise Injury

齐柳;宋勇莉;岳波;梁鹏飞;陈俊;李薇;邱建华;查定军;

1:空军军医大学第一附属医院西京医院耳鼻咽喉头颈外科

摘要

目的探讨急性噪声损伤后耳鸣患者的耳鸣特点及预后。方法对61例(75耳)参加打靶训练后2周仍有持续性耳鸣的空军军医大学学员进行耳鸣残疾量表(THI)、耳鸣评价量表(TEQ)调查及耳鸣心理声学检测,并给予耳鸣咨询及金纳多治疗一个月,随访6个月分析结果。结果 61例(75耳)耳鸣者中,左耳45例,右耳2例,双耳14例;耳鸣主调频率主要在4 000～8 000 Hz 65耳(86.67%),平均为5 708±1 568 Hz;耳鸣响度≤10 dB SL 74耳(98.67%),平均为2.714±2.46 dB SL;Feldman掩蔽曲线主要为汇聚型(54耳, 72%)和重叠型(13耳,17.33%);残余抑制试验阳性61耳(81.33%);耳鸣的严重程度多为轻中度(Ⅰ～Ⅲ级);伴耳鸣相应频率听阈下降者61耳(81.33%),听阈正常14耳(18.67%)。随访6个月后耳鸣消失35例(57.38%),减轻24例(39.34%),无变化2例(3.28%),其中耳鸣未消失者打靶后两周的纯音听阈均值(44±18.85 dB HL)及耳鸣频率(6 204.45±1 364.51 Hz)显著高于耳鸣消失者(分别为28.15±14.48 dB HL,5 446.18±1 520.17 Hz)(P<0.05)。结论打靶后2周持续性耳鸣者耳鸣的主调声频率为高频,掩蔽曲线以汇聚型为主,残余抑制试验多为阳性,打靶后6个月仍有持续耳鸣者打靶后2周患耳的纯音听阈及耳鸣频率均高于耳鸣消失者。

关键词

急性噪声损伤;射击;耳鸣;心理声学

基金项目(Foundation):

作者

齐柳;宋勇莉;岳波;梁鹏飞;陈俊;李薇;邱建华;查定军;

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齐柳宋勇莉岳波梁鹏飞陈俊李薇邱建华查定军