WHO关于耳疾与听觉障碍调查方案在贵州省的实施报告

目的：在贵州省开展以人群为基础的耳疾和听力减退患病率、病因和需求的调查。方法：用容量比例概率抽样（PPS）方法对贵州省30个调查点6 626人进行听力和耳疾调查（WHO方案）。结果：听力减退患病率为17.1%,全国标准化患病率为17.6%,其中轻度11.0%,中度4.2%,重度1.4%,极重度0.5%;男性患病663人（20.2%）,女性患病468人（14.0%）。听力残疾患病率为6.1%,全国标化率6.5%;引起听力减退的可能原因：耳疾31.4%,非感染因素42.5%,遗传因素6.7%,传染病0.4%,病因不明29.3%。13.8%的调查对象需要耳科和听力学干预,助听器需求占首位（9.1%）。结论：听力减退和听力残疾患病率较过去20年明显升高,为政府制定预防和控制耳聋计划提供了科学依据。     

吉林省听力障碍及耳疾流行病学调查研究

目的明确吉林省以人群为基础的耳疾与听力障碍的流行病学情况,为吉林省耳疾的防治工作提供科学依据。方法应用《WHO耳疾与听觉障碍调查方案》,通过容量比例概率抽样(PPS)的方法选择40个调查点,实际调查人数为6976人。耳聋残疾的定义和听觉障碍程度的分级采用WHO/PDH97.3推荐的标准,采用EARFORM V6.2(由WHO提供)软件进行资料输入和基本分析。结果911(13.1%)人有听力减退,311(4.5%)人存在听力残疾;城乡人群听力减退率和听力残疾患病率差异无显著性;男性听力减退和听力残疾患病率明显高于女性,差异有显著性;听力减退和听力残疾主要集中在60岁以上人群;患病率较高的耳疾病有耵聍(1.2%),慢性化脓性中耳炎(0.7%),鼓膜干性穿孔(1.4%),分泌性中耳炎(1.0%);19.3%的调查对象需要耳科或听力干预。结论所有听力减退的人群中,老年性耳聋患病率最高。听力残疾的患病率有上升的趋势,急需制定新的预防和治疗听力障碍和耳疾病的政策。     

贵州省0～14岁儿童听力障碍流行病学调查

目的 了解贵州省0～14岁儿童耳疾和听力障碍现患率、病因和干预需求的情况.方法 根据WHO方案,用容量比例概率抽样(PPS)方法调查贵州省30个点人群的听力和耳疾情况,抽取其中0～14岁儿童2 068人的资料进行统计分析.结果 0～14岁儿童听力减退现患率为3.48%,听力残疾现患率为1.84%,明显高于国内其他省市水平;7～14岁组听力残疾现患率为2.66%,显著高于0～6岁组(0.51%);男性儿童听力减退现患率为4.22%,显著高于女性儿童(2.54%).听力减退的可能原因分别是:耳疾50.00%(其中急慢性中耳炎占37.40%)、非感染因素11.11%、遗传性聋20.83%、病因不明27.77%.3.58%的调查对象需要得到药物或外科手术治疗;2.32%患儿需要佩戴助听器.结论 贵州省0～14岁儿童听力残疾现患率高于国内其他省市水平,中耳炎是引起儿章听力障碍的主要病因,且儿童遗传性聋比例也较高.     

贵州省老年前期与老年期人群耳疾与听力减退的流行病学调查

目的调查目前贵州省老年前期与老年期（≥45岁）人群听力减退与耳疾的流行病学情况,为制定耳聋防治、康复计划提供科学依据。方法根据WHO方案,用容量比例概率抽样方法调查贵州省30个点的听力和耳疾情况,抽取年龄≥45岁的1554人进行统计分析。结果≥45岁人群听力减退率为49.3%（全国标准化率为47.5%,贵州标准化率为47.4%）,其中轻度30.9%,中度13.0%,重度4.5%,极重度0.9%;听力残疾率为18.4%（全国标准化率为18.5%,贵州省标准化率为18.1%）;性别、城乡及年龄组间听力减退差异有统计学意义。≥60岁（老年期）人群听力减退率为72.6%,听力残疾率为29.9%。听力减退的可能病因分别是：耳疾28.6%,传染病0.1%,遗传因素4.4%,非感染状况53.4%,病因不明24.3%（1人可有多种原因,故总数〉100%）。1554名受检者中32.0%（498人）需要一项或多项干预治疗,其中85人次（5.5%）需要药物治疗,407人次（26.2%）需要配戴助听器,29人次（1.9%）需要外科手术治疗,18人次（1.2%）需要其他治疗。结论随着社会经济进程的加快,老年前期与老年期的听力减退和听力残疾率也迅速增长,老年性聋所占比例较大,应认真做好老年保健,提高听力减退的防治和康复技术,提高中老年人的生活质量和健康水平。     

西安市中学生听力现况调查

目的了解目前中学生听力状况,为制定中学生人群听力损失的防治策略提供科学依据。方法用分层随机整群抽样法对西安市中学生行问卷调查、耳科查体、纯音测听及声导抗测试,数据用SPSS15．0统计软件处理。结果1．共调查1567人,男生793人（50．61％）,女生774人（49.39％）。2．听力情况：听力减退患病率2．30％（36／1567）,听力残疾患病率0．13％（2／1567）。传导性听力减退13人,感音神经性听力减退20人,混合性听力减退3人。3．噪声性听力减退、中耳炎,耵聍栓塞等是引起中学生听力减退常见疾病。4．Logistic回归结果显示,性别、MP3／MP4使用时间、睡眠、耳聋家族史,耳毒性药物史等因素均与听力减退相关;MP3／MP4是听力损伤的独立危险因素。5．“耳科正常中学生”各频率听力受损的可能性随着MP3／MP4使用时间的延长而增大。6．“耳科正常中学生”声导抗检测鼓室图绝大多数为A型,无B型图。结论目前中学生人群中听力减退患病率较高。长时间、高音量使用MP3,MP4是中学生听力减退重要原因。失眠、耳聋家族史、耳毒性药物史等是中学生听力减退的危险因素。     

江苏省≥10岁人群的眩晕流行病学调查研究

目的调查江苏省人群中眩晕的分布情况及相关因素，为制订防治策略提供科学依据。方法采用按容量比例概率抽样（PPS）方法，在江苏省常住人口中抽样，对其中≥10岁的6854人进行眩晕问卷调查、纯音测听和耳科检查。结果本研究实际接受调查6333人，应答率92．4％，男3035人（47．9％），女3298人（52．1％），年龄10～93岁。被调查人群中眩晕的总体患病率为4．1％（标化患病率：全国3．4％，江苏3．6％），眩晕患病率随年龄增加呈上升趋势（P=0．000）。女性眩晕患病率（5．3％）高于男性（2．8％）（P=0．000），城乡之间差异无显著性（农村4．3％。城镇3．8％．P=0．459）。听力减退、中耳炎病史、噪声暴露史是眩晕的危险因素，OR值分别为2．186、2．135、1．609。结论眩晕在江苏省人群中较为常见，其发生与多种因素有关，必须加强这些方面的防治研究。     

贵州省少数民族耳疾与听力障碍流行病学调查报告

目的 调查目前贵州省少数民族人群听力障碍与耳疾的流行病学情况,为该地区耳聋防治提供科学依据.方法 根据WHO方案,用容量比例概率抽样方法调查贵州省30个抽样点共6 626人的听力和耳疾情况,抽取调查人群中17个民族的资料进行统计分析.结果 少数民族听力减退总的现患率为16.77%,其中侗族为25.93%,土家族为19.39%.白族为18.50%,苗族为15.84%,布依族为12.87%,穿青族为11.63%,其他民族为8.22%.少数民族听力残疾总现患率为6.13%,其中土家族现患率(11.03%)最高.贵州省少数民族的听力减退及听力残疾现患率与汉族(分别为17.15%和6.03%)比较差异无统计学意义(P＞0.05).少数民族耳疾现患率为17.11%,明显高于汉族(12.31%)(P＜0.001),其中以分泌性中耳炎和耵聍栓塞现患率最高.中耳炎是贵州省少数民族人群听力残疾的首要病因.结论 贵州省少数民族与汉族听力残疾现患率均明显高于全国平均水平,其中中耳炎致残占相当大的比例,提示有效防治中耳炎是防聋治聋的重要工作.     

中国听力残疾构成特点及康复对策

目的通过对全国第二次残疾人抽样调查所获得的基础数据进行分析，掌握听力残疾群体的规模、分布、残疾等级及年龄特点，为制订听力残疾的康复策略提供依据。方法依据全国第二次残疾人抽样调查数据库资料，按照描述现状→分析原因→提出对策的思维模式，提出适合于中国国情的听力残疾防治对策。结果全国听力残疾（含多重残疾）人共2780万，其中单纯听力残疾人2004万，多重残疾人中有听力残疾人776万。听力残疾现残率为2．11％，其中城市现残率为1．79％，农村现残率为2．27％，农村高于城市。听力残疾（含多重残疾）以60岁及以上老年人为主，占73．58％，其次是15～59岁组，占24．89％，7～14岁组占1．04％，0～6岁组占0．49％。60岁及以上组昕力残疾三、四级占79．13％，4～6岁组一、二级残疾占67．36％，0～3岁组一、二级残疾占83．90％，可见听力残疾在老年人中以轻、中度聋居多，在儿童中以重度、极重度聋居多；15岁及以上人群以单纯听力残疾为主，占72．65％，0～14岁听力残疾以多重残疾为主，占64．55％；农村听力残疾发生危险性是城市的1．27倍。对策面对2780万庞大的听力残疾群体，亟待建立健全社会保障和专业技术社区服务网络体系。     

广西自治区听力残疾人抽样调查结果分析

目的根据广西自治区第二次全国残疾人抽样调查的资料,调查分析广西自治区听力残疾人的数量、地区分布、致残原因等。方法采用分层、多阶段、整群、概率比例抽样方法进行残疾人口调查。全自治区共抽查25个县（市、区）、100个乡（镇、街道）,共200个调查小区。每个调查小区常住人口约400人,调查总户数22569户,实际调查量为80712人,调查的抽样比1．73％。应用数字式便携听力计对每位调查对象进行听力检测,问卷调查病史,专科医师体检并作出病因诊断。结果5837名残疾人中,听力残疾1467人,占总残疾人数的25．13％,居所有残疾之首;其中一级听力残疾70人（4．77％,70／1467）;二级听力残疾127人（8．66％,127／1467）;三级听力残疾689人（46．97％,689／1467）;四级听力残疾581人（39．60％,581／1467）。主要致残原因：老年性聋911人（62．10％,911／1467）;原因不明155人（10．57％,155／1467）;耳疾158人（10．77％,158／1467）;全身性疾病111人（7．57％,111／1467）;其他132人（8．99％,132／1467）。男性821人（56％）,女性646人（44％）,性别比为1．27：1。农村居民910人（62％）,城市居民557人（38％）。年龄分布：0～岁3人（O．20％）,7～岁10人（0．68％）,18～岁215人（14．66％）,≥60岁1239人（84．46％）。结论听力残疾在广西所有残疾人口中发生率最高,以中老年性聋和耳疾占大多数。     

耳科疾病和听力损失的基层防治--WHO最新纲领和我国的应答与思考

听力损失是全世界流行最广的感觉器官疾病,且随着人口老龄化等因素的影响,其患病率不断上升。WHO于2013年3月公布,2005～2012年间听力残疾者占全球人口的比例由4.2%（2.78亿）上升到5.3%（3.6亿）。其中,91%（3.28亿）为成人,9%（3200万）为儿童,65岁以上老年人约1/3为听力残疾,而更多的人患有未达残疾标准的听力减退。WHO听力残疾标准为：成人（15岁及以上）为较好耳0.5、1、2、4 kHz平均听阈大于40 dB HL;儿童（0～14岁）为较好耳0.5、1、2、4 kHz平均听阈大于30 dB HL［1,2］。     

a report of who ear and hearing disorders survey in guizhou province

Objective To report a population-based survey on the prevalence, pathogenic factors and medical needs of ear diseases and hearing loss. Methods Using the probability proportion to size (PPS) method, 6626 residents were investigated in 30 clusters in accordance with the WHO protocol. Results The prevalence of hearing loss was 17.1%(compatible with the natioanal standardized rate of 17.6%), including mild (11.0%), moderate (4.2%), severe (1.4%), and profound (0.5%)impairment. Of the 1131 individuals with hearing loss, 663 (20.2%) were male and 468 (14.0%) were female. The prevalence of hearing disability was 6.1%(again compatible with the national standardized rate of 6.5%). The causes of hearing loss were ear diseases (31.4%), non-infectious ear disorders (42.5%), genetic disorders (6.7%), infectious disease (0.4%) and undetermined causes (29.3%). Of the hearing impaired people, 13.8% needed otologic and/or audiologic interventions and 9.1% needed hearing aids. Conclusion The prevalence of hearing loss and hearing disability have increased in the past twenty years. The data pro-vide important information for authorities in formulating policies for prevention and management of deafness.     

The prevalence of hearing impairment amongst Maori schoolchildren

A survey of hearing amongst a population of Maori schoolchildren in the eastern North Island of New Zealand has demonstrated a high prevalence of hearing impairment. Out of 194 children undergoing audiometry an impairment of 20 dB or greater at 0.5, 1.2 and 4 kHz was found in the worse hearing ear in 29% and in the better hearing ear in 12%. Comparison with a similar survey done in the same valley in 1977 revealed an apparent reduction in the prevalence of hearing loss and the prevalence of otitis media. This improvement appears to be due to a reduced prevalence of otitis media. An unexpected finding was that at least 2% of the children had a bilateral sensorineural hearing impairment.     

Auditory status of persons with intellectual disability at the German Special Olympic Games

Among persons with intellectual disability, the prevalence of hearing impairments is high. During the German Special Olympics Summer Games 2004, a hearing screening was conducted on 755 athletes with intellectual disabilities. Obligatory screening included ear inspection and recording of otoacoustic emissions, and optional screening included tympanometry and brief pure-tone audiometry. 38.0% of the athletes failed the screening. 53.0% needed ear wax removal. 56.1% of the fails indicated sensorineural hearing loss and 13.6% indicated mixed hearing loss. 12.5% of the fails were caused by unremovable ear wax, 1.4% by ear canal affections, and 16.4% by middle ear problems. Left ear fails were more frequent than right ear fails. A peripheral hearing disturbance can thus be expected in every third subject. The high failure rate, a considerable percentage of previously undetected profound hearing loss (1.1%), and the frequent need for ear wax removal, suggest that nearly half of persons with intellectual disabilities need regular otological or audiological consultations.     

改良中国学龄儿童听力调查问卷在大规模听力减退流行病学调查中的应用

目的:探索改良中国学龄儿童听力调查问卷在大规模听力减退流行病学调查中的准确性及可行性。方法:依照WHO方案,用按容量比例概率抽样方法对江苏省40个调查点8412人进行耳科疾病和听力减退调查,87.9%(7岁以上)被查人群有完整问卷资料,同时进行金标准测试(纯音测听)作为参照。结果:问卷得到听力减退的患病率为12.9%,与金标准测试结果相比,灵敏度为58.5%,特异度为96.7%,阳性预测值为78.9%,阴性预测值为91.7%,符合率为90.0%,问卷对女性灵敏度高于男性。结论:作为大规模听力筛查的方法,中国学龄儿童听力调查问卷的特异度高,灵敏度尚需提高。     

The prevalence and causes of hearing impairment in Oman: a community-based cross-sectional study

A community-based nationwide survey for hearing loss was conducted in Oman in 1996–97. Audiometric tests and ear examinations were conducted for 12 400 persons in phase I. For children aged less than 4 years, subjective screening tests were used. In phase II, otologists examined the hearing-impaired subjects to determine the cause. The prevalence of bilateral hearing impairment was 55/1000 (95% CI 51.08–59.47). Gender difference was not significant. The rates were 325/1000 and 17/1000, respectively, in the _60-year and _10-year age groups. Presbyacusis and middle ear diseases, respectively, were the causes of 33% and 20% of bilateral hearing impairment. In 30% of the bilateral hearing-impaired subjects, the cause could not be determined. The prevalence of bilateral disabling hearing loss was 21/1000 (95% CI 18.07–23.29). Noise-induced trauma was responsible for only 1.4% of cases of disabling hearing loss. Establishing primary ear care, introducing hearing screening for neonates and schoolchildren, promoting safe preventive practices for ear care, strengthening secondary-level ear care services and introducing comprehensive rehabilitative initiatives for the hearing-disabled are recommended to reduce the hearing loss rates.     

The prevalence and causes of hearing impairment in Oman: a community-based cross-sectional study

A community-based nationwide survey for hearing loss was conducted in Oman in 1996-97. Audiometric tests and ear examinations were conducted for 12,400 persons in phase I. For children aged less than 4 years, subjective screening tests were used. In phase II, otologists examined the hearing-impaired subjects to determine the cause. The prevalence of bilateral hearing impairment was 55/1000 (95% CI 51.08-59.47). Gender difference was not significant. The rates were 325/1000 and 17/1000, respectively, in the > or = 60-year and < 10-year age groups. Presbyacusis and middle ear diseases, respectively, were the causes of 33% and 20% of bilateral hearing impairment. In 30% of the bilateral hearing-impaired subjects, the cause could not be determined. The prevalence of bilateral disabling hearing loss was 21/1000 (95% CI 18.07-23.29). Noise-induced trauma was responsible for only 1.4% of cases of disabling hearing loss. Establishing primary ear care, introducing hearing screening for neonates and schoolchildren, promoting safe preventive practices for ear care, strengthening secondary-level ear care services and introducing comprehensive rehabilitative initiatives for the hearing-disabled are recommended to reduce the hearing loss rates.