2014版职业性噪声聋诊断标准临床应用

发布时间：2018-06-01 10:19

本文选题：职业性噪声聋 + 纯音听阈　；参考：《中国职业医学》2017年03期

【摘要】：目的分析GBZ 49—2014《职业性噪声聋的诊断》(以下简称"GBZ 49—2014")的修订对职业性噪声聋(ONID)诊断结论的影响。方法采用判断抽样方法,以77例进行ONID诊断和鉴定的病例为研究对象,收集其纯音听阈测试结果,分别采用GBZ 49—2014和GBZ 49—2007《职业性噪声聋诊断标准》(以下简称"GBZ 49—2007")进行诊断,比较诊断听阈值和诊断分级的变化情况。结果 77例研究对象采用GBZ 49—2014计算的较好耳听阈加权值、双耳高频平均听阈(BHFTA)分别高于采用GBZ 49—2007计算的较好耳语频平均听阈和BHFTA[(32.4±10.3)vs(29.8±10.6)dB,(50.5±13.3)vs(49.1±13.6)dB,P0.01]。采用GBZ 49—2014和GBZ 49—2007对研究对象进行ONID诊断的结论一致性较好(Kappa值=0.92,P0.01)。但2个版本诊断标准对研究对象ONID的诊断分级结果差异有统计意义(P0.05),采用GBZ 49—2014进行诊断分级时,3例采用GBZ 49—2007诊断为非ONID者被诊断为轻度ONID,有5例采用GBZ 49—2007诊断为轻度ONID者被诊断为中度ONID。结论依据GBZ 49—2014计算的诊断听阈值高于依据GBZ 49—2007计算者;依据GBZ 49—2014诊断可导致ONID诊断病例数增加,并导致诊断分级加重。
[Abstract]:Objective to analyze the effect of GBZ 49-2014 "diagnosis of occupational noise deafness" (hereinafter referred to as "GBZ 49-2014") on the diagnosis of occupational noise deafness. Methods A total of 77 cases diagnosed and identified by ONID were studied by the method of judging sampling, and the results of pure tone audiometry were collected. GBZ 49-2014 and GBZ 49-2007 (GBZ 49-2007) were used in the diagnosis of occupational noise deafness, respectively. The changes of diagnostic auditory threshold and diagnostic grading were compared. Results the weighted value of better auditory threshold calculated by GBZ 49-2014 was higher than that of GBZ 49-2007 and BHFTA [32.4 卤10.3)vs(29.8 卤10.6dBP0.01]. GBZ 49-2014 and GBZ 49-2007 were used in the diagnosis of ONID. However, there was statistical significance between the two versions of diagnostic criteria for the diagnosis and grading of ONID in the study subjects (P 0.05). 3 cases with GBZ 49-2007 as non-ONID were diagnosed as mild ONIDs, and 5 cases with GBZ, when GBZ 49-2014 was used to classify the patients. 49-2007 patients with mild ONID were diagnosed as moderate ONIDs. Conclusion the diagnostic auditory threshold calculated by GBZ 49-2014 is higher than that calculated by GBZ 49-2007, and the diagnosis based on GBZ 49-2014 can increase the number of ONID cases and aggravate the diagnostic grading.
【作者单位】：同济大学附属杨浦医院;
【基金】：上海市公共卫生重点学科建设项目:环境卫生学与劳动卫生学(5GWZK0201)
【分类号】：R135.8

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