高原低氧环境下鞭炮噪声对正常发育儿童听觉的影响

目的：了解鞭炮所产生的脉冲噪声对高原环境下正常生长儿童听觉的影响。方法：选择秦岭山区71例、青海湖周边牧区50例正常发育,每年近距离接触鞭炮噪声3次以上的学龄（6～12岁）儿童,实地测试全频听力阈值,并以南京市50例儿童作为对照,对比分析听觉状况。结果：山区和高原乡村男性儿童超高频听力较差;除个别低频外,高原相对缺氧环境与平原山区之间男性儿童听力无明显差异。三地女性儿童除个别低频外听力无明显差异。结论：高原相对低氧环境不影响女性正常儿童的听力发育;通过听觉对比,高原相对低氧环境下接触鞭炮脉冲噪声对男性儿童听觉损害的程度并不高于平原山区。     

肾虚对噪声作业工人听力的影响

目的 探讨肾虚对噪声作业工人听力的影响,寻找一种简便易行的噪声易感人群筛选方法.方法 175名噪声作业工人为观察组,分别进行辨证分型 60名未接触噪声的行政人员为对照组.调查各观察对象的耳部自觉症状并测试纯音听力,比较各种症状和听力水平的组间差异.结果 观察组中肾虚型（65人）,非肾虚型（110人）,肾虚型出现耳鸣症状者明显多于其它组（P＜0.005）.纯音测听结果显示,各组语言频率听阈比较差异无统计学意义（P＞0.05）,但肾虚组高频平均听阈明显差于其他两组（P＜0.05）.结论 肾虚可以加重噪声对听力的损害,肾虚证候可以作为噪声易感人群筛选的一个重要指标.     

某石化总厂噪声环境作业人员听力状况调查

目的了解某石化总厂噪声作业人员听力状况,探讨噪声环境是否对其造成听觉损伤,为企业监督管理提供依据。方法选择某石化厂1033名噪声环境作业人员作为调查组,同厂200名不接触噪声的管理人员作为对照组,均进行纯音听阈测试,了解听力损失情况,并分析年龄、工龄及噪声强度与噪声性听力损伤的关系。结果调查组中,排除125名非噪声性听力损失（中耳疾病,不包括中耳疾病合并噪声性听力损失）者,其余908名噪声作业人员中,听力正常555人（61．12％）,轻度高频听力损失301人（33．15％）,双耳高频平均听阈≥40 dB H L、但较好耳语频听阈正常者（噪声岗位观察对象）47人（5．18％）,轻度噪声性听力损失4人（0．44％）,中度噪声性听力损失1人（0．11％）。对照组中,轻度高频听力损失17人（8．50％）,噪声岗位观察对象6人（3．0％）。调查组轻度高频听力损失及噪声岗位观察对象检出率均明显高于对照组;噪声性听力损失与作业人员的年龄、工龄以及接触的噪声岗位强度有关。结论噪声作业人员高频听力损失发生率明显高于普通人群。随着作业人员的年龄、工龄增长以及接触的噪声强度提高,噪声性听力损失呈现逐渐加重的趋势。     

单纯血液透析对听力的影响

慢性肾功能衰竭病人经过血液透析可出现不同程度的感音神经性听力损害 ,如果这种听力损害没有引起内科医生的重视 ,将会给患者社交、语言方面带来严重影响。导致后天性听力损害的因素很多 ,如高血压、电解质紊乱、血中尿素氮改变、高脂血症、血液透析疗法。该作者列举了以前的报道 ,有人认为 :血液透析和听力损害有一定关系 ,如急性低血压患者 ,血浆渗透压降低、急性尿素氮清除、红细胞粘稠度增加、对透析膜的免疫反应 ,可导致耳蜗缺氧 ,在肾透析后期 ,血清的容量减少可导致血液成分改变。急性低血压和急性液体清除并存 ,可在某些器官的微循…     

坑道作业人员的听力损伤

部队坑道作业场所内的大型发电、通风、降湿设备运转时产生较强的噪声 ,其发电机组噪声可达95～ 1 0 5dB(A) ,风机噪声在 85～ 95dB(A)之间 ,大功率电机噪声都在 85dB(A)以上 ,以 2～ 4kHz稳态噪声为主 ,风机噪声还有 6～ 8kHz成分。坑道工作人员长时间在这种环境下工作 ,其听力易受到损伤。我们对 83例坑道工作人员进行听力调查 ,现分析报告如下。1　资料与方法1 .1 　 临床资料坑道工作人员 83例 ,均为男性。按参加坑道工龄分组。 <2年组 39例 ,年龄 1 8～ 2 5岁 ,平均2 1岁 ;2～ 5年组 2 5例 ,年龄 2 0～ 30岁 ,平均 2 3岁 ;>5年组 1…     

唇腭裂对中耳及听力的影响

唇腭裂对中耳及听力的影响李利平，陈英茹唇腭裂为颌面部常见的先天畸形，据报道发病率约为１：１０００。临床资料观察发现，该类患儿常伴有中耳疾患，乃致影响听力及言语功能。本文通过耳镜检查、纯音测听、声导抗测试，观察唇腭裂对中耳功能及听力损失程度，现报告如下...     

腺样体肥大对儿童听力的影响

目的 观察腺样体肥大对儿童听力的影响及手术后儿童听力的恢复情况.方法 回顾性研究手术治疗的腺样体肥大患儿140例,术前行声导抗和纯音听阈检测,术后1周复查听力学检查,分析肥大腺样体对患儿听力的影响以及手术后的听力康复情况.结果 全组病例中,主诉有听力下降者93例,其内20例(21.51％)表现有不同程度的感音神经性聋;声导抗检查88例(165耳)为B型曲线,5例(9耳)为C型曲线.47例无自觉听力下降,但听力学检查结果显示29例(53.19％)存在单耳或者双耳听力下降;声导抗检查30例(63.83％)存在声导抗鼓室曲线的异常,B型曲线22例,C型曲线8例.腺样体切除并行鼓膜置管术后,所有患儿听力均明显提高,与术前相比差异有统计学意义(P＜0.05).结论 腺样体肥大可引起传导性听力下降,部分还表现感音神经性听力下降.腺样体切除联合鼓膜置管术能有效恢复患儿听力.     

噪声对机场机务人员听力影响的调查

机务人员长期工作在飞行噪声环境中 [噪声强度≥ 12 0ｄＢ(Ａ) ],距离噪声源 2 0～ 10 0米 ,特别在飞机试车、起飞、加速的过程中 ,对听力影响很大 ,故笔者对某场站机务人员进行听力调查 ,报告如下 :1　资料与方法1.1　一般资料　在某飞行场站 2 0 0余人机务大队中 ,随机抽取 6 7人作为机务组 (均未采取听力防护措施 ) ,年龄 2 0～ 37岁 ,服役年限 2～ 7年 ,服务机种主要是歼 6、歼 7,并以同一地点工作未接触噪声的健康官兵 6 7人作为对照组。1.2　方法　每个对象经耳镜检查 ,排除中耳炎、外耳道炎、耵聍栓塞。填写听力调查表后进行纯音测听…     

飞机场噪声对机务人员听力的影响

采用问卷式调查及纯音测听，对１００例歼击机场接触噪声的机务人员。和１００例同一地 未接触噪声的健康官兵，进行听力调查。．结果发现前者有５１例听力减退，为双侧感音神经性聋；听力减退主要频率在高频区，其中３２例４ｋＨｚ出现Ｖ形切迹。     

Psychosocial work environment,hearing impairment and health

This article summarizes results from a study of hearingimpaired men and women in the labour force in Sweden. A questionnaire about psychosocial work environment (in accordance with the Demand-Control Model), health and wellbeing was sent out and answered by 445 hearingimpaired people, 20-64 years of age. A large reference group had previously answered the same questionnaire. The results indicate that imbalances between demand and control (i.e. high demand and low control, so-called high stress work type) is more common among hearingimpaired people than in the reference group. The outcome of the combination high demand and low control among hearing-impaired people is (much) worse than among hearing-impaired people with other work types ( passive, active, low stress). Hearing-impaired people with the high-stress work type more frequently report bad physical health status and psychological wellbeing regarding a number of indicators. There is, moreover, a tendency for women to be worse off than men. Our data suggest that those involved in audiological rehabilitation should pay great attention to hearing-impaired people with jobs that can be characterized as high stress.     

高原地区难治性鼻出血病例分析

摘要：目的研究高原地区难治性鼻出血的发病特点,为当地开展鼻出血的防治提供依据。方法收集后藏地区难治性鼻出血患者63例,分析其出血原因,鼻内镜下寻找出血部位并进行治疗。结果后藏地区难治性鼻出血的主要病因为高血压,主要诱因为气候干燥和不良生活习惯;出血部位主要在鼻中隔前端、嗅裂区及鼻中隔上部、下鼻道后穹隆部、中鼻道后末端。结论高原地区难治性鼻出血发病有地域特征性,应结合高原特点开展鼻出血的防治工作。     

Introducing real-life listening features into the clinical test environment: Part I: Measuring the hearing performance and evaluating the listening effort of individuals with normal hearing

Objective: Controlled clinical test environments are very different from real-life listening situations in which speaker and background noise level variations can hinder a person’s ability to hear and follow conversations. This study was performed to evaluate the ability of people with normal hearing to follow a single speaker in the presence of background noise, and to explore relations between those measures and the listeners’ subjective assessments, listening effort, and sound quality judgements.

Methods: A group of adults with normal hearing were evaluated using the following battery of tests: (i) Roving Level Test, (ii) the Just Understanding Speech Test, (iii) Performance Perceptual Test, (iv) the Visual Analogue Scale to evaluate listening effort, and (iv) with a sound quality questionnaire.

Results: The results show that people with normal hearing tend to accurately estimate their hearing abilities, and both the listening effort required and speech recognition thresholds tend to increase with increasing background noise.

Discussion: Implementing a battery of tests that evaluate speech-in-noise listening abilities, listening effort, and subjective hearing perception might provide greater insight into hearing performance than traditional measures. Additionally, the data generated in this study can be used for comparison with measures obtained from hearing impaired and hearing device listeners, and as such, has the potential to guide counselling and rehabilitation to a range of clinical populations.

Conclusion: The examination of both the self-estimated and verified performance measurements in simulated real-life listening situations can provide audiologists with a comprehensive and realistic profile of a person’s hearing performance.     

Questionnaire investigation of musicians' use of hearing protectors, self reported hearing disorders, and their experience of their working environment

Musicians in symphony orchestras are exposed to harmful sound levels. Although research shows that industrial workers have a higher propensity to noise-induced hearing loss, musicians can also develop a hearing loss from noise exposure. Furthermore, musicians can suffer from tinnitus, hyperacusis, and distortion, among other hearing disorders, which can affect their work more severely than a hearing loss. This study investigated the use of hearing protectors, the prevalence of self-reported hearing disorders among musicians, and the importance of these hearing disorders to the musicians. The musicians at three Danish symphony orchestras were asked to complete a questionnaire on the topic. Results showed that Danish musicians are aware of the dangers of loud music, yet they rarely use hearing protectors and not always correctly; however, musicians with hearing disorders use hearing protectors more frequently. In addition, the musicians questioned suffered from different hearing disorders. Education is needed to change musicians' opinion of hearing conservation and hearing protectors. The education must be directed to both the musicians and the administration of the symphony orchestras.     

The effects of acoustic environment after traumatic noise exposure on hearing and outer hair cells

Previous studies reported that exposure to non-traumatic level sounds after traumatic noise exposure reduced the degree of noise-induced hearing loss and hair cell stereocilia damage. The current study investigated the effects of a 3-day post-noise acoustic environment on the degree of noise-induced hearing loss and cochlear damage. Female chinchillas were exposed to traumatic continuous noise (4 kHz octave-band noise) at 107 dB SPL for 1 h and then placed in either an augmented acoustic environment (AAE) or deprived acoustic environment (DAE) for 3 days. The AAE group was exposed to a broad-band noise (4–20 kHz) at 80 dB SPL and the DAE animals were fit with conventional earplugs to minimize the level of acoustic stimulation. Auditory brainstem responses (ABRs) were recorded before and 3 days after the traumatic noise exposure. The AAE group showed a significantly lower average threshold shift at the frequencies of 4 and 8 kHz (p < 0.01). Correspondingly, significantly fewer missing and dying outer hair cells (OHCs) were observed in the AAE group than in the DAE group. Although the cochlear reduced and oxidized glutathione levels (GSH and GSSG, respectively) were essentially the same in two groups at day 3, significant correlations were found between GSSG levels and mean ABR threshold shift (1–16 kHz) in the AAE group; as well as GSSG and percentage of total OHC loss in the DAE group. The results suggest that post-noise acoustic environment influenced the degree of hearing loss and OHC deterioration after traumatic noise exposure.     

Introducing real-life listening features into the clinical test environment: Part II: Measuring the hearing performance and evaluating the listening effort of individuals with a hearing implant

Objectives: The controlled clinical test environment is very different from real-life listening situations, where the presence of additional speakers and variations in background noise signals can affect listening performances. The primary objective of this study is to reduce the gap between clinical results and real-life performances that are reported for many hearing implant users.

Methods: Similar to Part I of this study, hearing performance and sound perception are evaluated using the following tests: (i) the Roving Level Test, (ii) the Just Understanding Speech Test, (iii) the Performance Perceptual Test, (iv) the Visual Analogue Scale to evaluate the perceived listening effort required for a range of background noise levels, and (v) the Hearing Implant Sound Quality questionnaire. All subjects recruited for this study used MED-EL hearing implant systems.

Results: Results show that, similar to normal hearing listeners, hearing implant users tend to accurately estimate their hearing abilities, and both listening effort and speech recognition thresholds tend to increase with increasing noise.

Discussion: The proposed test battery for evaluating speech understanding and listening effort were suitable for use in this study as all of the implant users were able to complete the tests. This test battery can be used to provide audiologists with further information relating to real-life listening performances.

Conclusion: Evaluating the self-estimated and verified performance measurements of hearing implant users in real-life listening situations are essential for providing information regarding the discrepancies observed between the objective and subjective reports of hearing difficulties.