摘要
目的:观察爆震性聋的听力恢复过程,探讨听力损害机制。方法:对21例(39耳)早期爆震性聋患者定期作听力追踪测试,测得爆震后平均2.2h、8.6h、30.2h、4.8d、9.8d和21.6d的听阈变化。结果:39耳爆震伤后2.2h的0.25～8kHz气导、骨导纯音听阈均值(PTA)分别为45.1dBHL和35.2dBHL;8.6h分别为36.5dBHL和27.9dBHL;30.2h分别为28.2dBhL和20.4dBHL;4.8d分别为20.1dBHL和13.8dBHL;9.8d分别为14.9dBHL和9.1dBHL;21.6d分别为15.2dBHL和9.6dBHL。其间气-骨导间距从9.9dBHL缩小到5.6dBHL。21.6d后仍有5例(6耳)气导3、4、6、8kHz中一个或一个以上频率听阈级>25dBHL,这些病例在爆震后2.2h听力损害程度均为较重者。结论;爆震性聋听力恢复速度早期较快,逐渐变慢,在爆震后第9.8d测得最差听阈。第21.6d听阈略有恢复现象值得注意。早期听力损害严重者恢复不良。在鼓膜完整的爆震性聋中存在轻度可逆性传导性听力损害,表明中耳也有闭合性损伤。
Objective: To investigate the hearing recovering process of explosive deafness and discussion of the mechanisms of hearing damage. Methods: A series of audiometry on 21 cases (39 ears) of explosive deafness with intact drum were performed averagely after blast 2. 2 hours, 8. 6 hours, 30. 2 hours, 4. 8 dyas, 9. 8 days and 21. 6 days. Results: The hearing thresholds of air conduction (AC) and bone conduction (BC) in 0. 25 to 8kHz pure tone average (PTA) was 45.1dBHL and 35. 2dBHL after blast 2. 2 hours, 36. 5 dBHL and 27. 9dBHL after 8. 6 hours, 28. 2dBHL and 20. 4 dBHL after 30. 2 hours, 20. 1 dBHL and 13. 8 dBHL after 4. 8 days, 14. 9 dBHL and 9. 1 dBHL after 9. 8days and 15. 2dBHL and 9. 6dBHL after 21. 6 days respectively. In the meantime, A-B gap was decreased from 9. 9 to 5. 6dBHL. Among them, the hearing threshold was still small than 25dBHL in 5 cases (6 ears) on the 21. 6 days later at one or more frequencies of 3kHz, 4kHz, 6kHz and 8kHz of AC. There were serious in the hearing damage range 2. 2 hours after blast. Conclusion: The recovers of hearing threshold were quickly at early period of balst, and slowly at later. The hearing threshold was great serious at 9. 8 day after blast, and than recurrent at 21. 6 days of blast. The serious hearing trauma may be tends to incomplete recovery.
出处
《耳鼻咽喉（头颈外科）》
2003年第3期134-137,共4页
Chinese Arch Otolaryngology-Head Neck Surg
