老年人听力减退和耳疾流行病学调查研究

目的明确江苏省老年人听力减退和耳疾流行病学情况，为制订防治和康复计划提供科学依据。方法用容量比例概率抽样方法对江苏省40个调查点进行听力和耳疾调查（WHO方案），抽取年龄≥60岁的老年人共计1261人进行统计分析。结果听力减退患病率为58.1％（标准化患病率：全国59．5％，江苏省60.9％），其中轻度33．1％，中度17．8％，重度5.9％，极重度1.3％；听力残疾患病率为25．0％（标准化患病率：全国26．6％，江苏省28．1％）。年龄、性别、城乡之间的差异有统计学意义。耳疾的患病率为：外耳畸形0.2％，耵聍栓塞1．7％，外耳道炎0.1％，真菌感染0．5％，分泌性中耳炎1．2％，慢性化脓性中耳炎1.6％，鼓膜干性穿孔2.3％。引起听力减退的可能原因：耳疾2．9％，非感染状态92.6％，遗传因素0．3％，病因不明4，2％。干预需求：调查人群中31.1％需要配戴助听器，2．3％需要药物治疗，0.9％需要外科非急诊治疗，1.0％需要其他治疗。结论老年人听力减退和听力残疾患病率较1987年的调查明显升高，应引起政府和全社会的更多关注。制订和执行科学的防治和康复计划是完全必要和十分迫切的。

Epidemiologic study on hearing impairment and ear diseases in old people

Objective To investigate the prevalence of hearing impairment and ear diseases in old people and provide scientific data for drawing up the prevention and treatment strategies.Methods Using the probability proportion to size(PPS)method,1261 people over 60 years were investigated in 40 clusters in Jiangsu Province with the WHO protocol.Results The prevalence of hearing impairment was 58.1% (the standardized rate:59.5% in the whole country,60.9% in Jiangsu province).Degrees of hearing impairment were mild(33.1%),moderate(17.8%),severe(5.9%)and profound(1.3%).The prevalence of hearing disability was 25.0%(the standardized rate:26.6% in the whole country,28.1% in Jiangsu province).There were significant difference of the prevalence between male and female,as well as urban and rural,and different ages.The prevalence of the ear diseases was auricle malformation(0.2%), wax(1.7%),otitis externa(0.1%),fungi(0.5%),serous otitis media(1.2%),chronic suppurative otitis media(1.6%),dry perforation of tympanic membrance(2.3%).The causes of hearing impairment were ear diseases(2.9%),non-infectious condition(92.6%),genetic condition(0.3%)and undetermined causes(4.2%).Of which,31.1% of persons needed hearing aids while 2.3% of persons needed medicine treatment,but 0.9% of persons needed non-urgent surgery and 1.0% of persons needed other treatment.Conclusions The prevalence of hearing impairment and disability in the old rised obviously than the last investigation in 1987.It was a heavy burden for social development in China.The government and the whole society should take more concern about the problem.The scientific strategies of prevention and treatment were urgently needed and implemented.