本文關(guān)鍵詞：聽覺過敏的臨床特征及評估方法　出處：《鄭州大學》2014年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 聽覺過敏 耳鳴 偏頭痛 問卷調(diào)查 響度不適閾 耳聲發(fā)射

【摘要】：研究背景 耳科門診中耳鳴患者最多見，對耳鳴的臨床研究發(fā)現(xiàn)有些耳鳴患者不僅受耳鳴困擾，而且對正常環(huán)境中常人未感不適的聲音耐受度降低。Jastreboff曾報道耳鳴診療中心的60%耳鳴患者對日常生活中常人未感不適的聲音表現(xiàn)出異常反應，如不適、煩躁、緊張、害怕、恐懼等消極反應。早在1938年P(guān)erlman第一次提出“聽覺過敏（hyperacusis）”概念來描述聲過敏癥狀。聽覺過敏臨床特征主要表現(xiàn)為對環(huán)境中正常的聲音耐受度降低，并帶有不良情緒反應，嚴重者表現(xiàn)出精神癥狀和神經(jīng)癥人格特征，給患者生活帶來嚴重負面影響。 流行病學的調(diào)查顯示聽覺過敏發(fā)病率逐年增加，聽覺過敏的病因及發(fā)病機制尚無確切定論。目前臨床中應用的聽覺過敏評估方法，主要有問卷量表調(diào)查及聽力學檢測。由于不同國家之間文化及語言的差異，尚不存在國際統(tǒng)一通用的量表，國內(nèi)學者尚未對聽覺過敏臨床評估量表進行深入研究。 聽覺過敏與耳鳴常伴隨存在，臨床醫(yī)師常重點關(guān)注耳鳴而忽視聽覺過敏癥狀，導致耳鳴習服治療效果大大降低。聽覺過敏對患者的直接影響并不亞于耳鳴或者其他聽力疾病，但是由于臨床醫(yī)生對其癥狀表現(xiàn)及臨床評估缺乏認識，在診斷治療上往往陷入誤區(qū)。因此正確認識聽覺過敏對于其診斷、鑒別及有效治療有重要意義。 目的 本研究的目的是探討聽覺過敏的臨床特征，分析各種臨床評估方法并確定有效評估方法，，為進行臨床診治提供幫助。 方法 收集耳科門診中以聽覺過敏伴或不伴耳鳴為主訴就診患者的臨床資料，共60例，其中其中男性21例，女性39例；年齡13~71歲，平均年齡38.82±14.15歲。選擇20例無年齡和性別差異、無耳鳴及聽覺過敏的聽力正常志愿者作為正常對照組（C組），其中男10例，女10例；年齡13~70歲，平均年齡37.15±13.24歲。通過病史問卷表詳細詢問患者病史，以了解聽覺過敏病史特征。所有研究對象均填寫中文版聽覺過敏調(diào)查問卷量表，對量表得分結(jié)果進行整理分析，同時進行聽力學檢查，分析比較各組純音測聽、響度不適閾、畸變產(chǎn)物耳聲發(fā)射測試及對側(cè)聲刺激抑制試驗結(jié)果。 結(jié)果 60例聽覺過敏患者中49例（81.67%）伴有耳鳴，14例（23.33%）伴有頭痛。常見敏感聲音有小孩哭聲、尖叫聲、突然短促高調(diào)聲、電器噪聲、汽笛聲等。聽覺過敏組和聽覺過敏伴耳鳴組問卷總得分高于正常組(P0.05)，注意力、情緒子維度的得分受性別的影響，具有統(tǒng)計學差異性(P0.05)；聽覺過敏組和聽覺過敏伴耳鳴組響度不適閾值明顯低于正常組(P0.05)，LDL閾值與聽覺過敏問卷總得分、注意力、社會、情緒子維度得分的相關(guān)性得出兩者無相關(guān)性（P＞0.05）；聽覺過敏組和聽覺過敏伴耳鳴組對側(cè)聲刺激后畸變產(chǎn)物耳聲發(fā)射測試幅值與未抑制時比較無差異（P0.05）。 結(jié)論 聽覺過敏是個體生理和心理共同作用的一種臨床癥狀，臨床評估主要包括聽覺過敏主觀癥狀問卷調(diào)查及聽力學檢查。中文版本聽覺過敏調(diào)查問卷具有可靠性性和有效性，能夠應用于臨床量化評估聽覺過敏對患者生活的影響。畸變產(chǎn)物耳聲發(fā)射可評價聽覺過敏耳蝸功能。
[Abstract]:Research background
In the most common otology clinic patients with tinnitus, clinical study of tinnitus found some tinnitus patients not only by tinnitus, and discomfort of ordinary people are not the normal environment of sound tolerance reduce.Jastreboff reported tinnitus treatment center 60% tinnitus patients of ordinary people in daily life are not sound discomfort showed abnormal responses such as discomfort, irritability, tension, fear, fear and other negative effects. As early as in 1938, Perlman first proposed the "hyperacusis (hyperacusis)" concept to describe the sound of allergic symptoms. Hyperacusis main clinical features of the environment in a normal voice tolerance decreased, and with negative emotional reactions, serious show mental symptoms and neurotic personality characteristics, bring serious negative impact on the life of patients.
Epidemiological surveys show that hyperacusis incidence increased year by year, the etiology and pathogenesis of allergic hearing is no definite conclusion. Hyperacusis evaluation method of clinical application at present, mainly include questionnaire survey and audiology. Due to cultural and language differences between different countries, there is no unified international general scale, domestic scholars yet for the hyperacusis clinical assessment of in-depth study.
Hyperacusis and tinnitus often accompanied by the existence of, clinicians often focus on tinnitus and ignore auditory allergy symptoms, cause tinnitus retraining therapy effect is greatly reduced. Hyperacusis is not less than tinnitus or other disease to directly affect the patient's hearing, but due to the lack of awareness of clinicians and clinical evaluation in diagnosis and treatment of their symptoms, often misunderstand. So a correct understanding of hyperacusis for its diagnosis, has important significance in differential and effective treatment.
objective
The purpose of this study is to explore the clinical features of auditory hypersensitivity, to analyze various clinical evaluation methods and to determine effective evaluation methods for clinical diagnosis and treatment.
Method
In order to collect hyperacusis with or without clinical data of patients with tinnitus in otology clinic, a total of 60 cases, including 21 males and 39 females; aged 13~71 years, mean age 38.82 + 14.15 years old. 20 cases of no age and gender differences, no tinnitus and hyperacusis as normal hearing volunteers the normal control group (C group), 10 cases were male, 10 were female; aged 13~70 years, mean age 37.15 + 13.24 years history. Through the questionnaire asked in detail about the patient's history to understand the characteristics of auditory allergy history. All of the subjects were in Chinese auditory sensitive version questionnaire, the score results by analyzing and audiological examination were analyzed and compared, pure tone audiometry, loudness discomfort threshold test and contralateral acoustic stimulation inhibition test results of distortion product otoacoustic emission.
Result
60 cases of hyperacusis patients in 49 cases (81.67%) accompanied by tinnitus, 14 cases (23.33%) accompanied by headache. Common sensitive voice of a child crying, screaming, suddenly high-profile short sound, electrical noise, whistle. Auditory allergy and hyperacusis and tinnitus questionnaire total score higher than the normal group (P0.05). Attention, emotional impact sub dimension scores by gender, with statistical difference (P0.05); auditory allergy and hyperacusis and tinnitus loudness discomfort threshold group was significantly lower than the normal group (P0.05, LDL) threshold and hyperacusis Questionnaire total score, attention, social, emotional dimension scores correlation between the two no correlation (P > 0.05); auditory allergy and hyperacusis and tinnitus group contralateral acoustic stimulation after DPOAE amplitude and no inhibition test showed no significant difference (P0.05).
conclusion
Hyperacusis is a common clinical symptom of individual physiological and psychological, clinical evaluation mainly includes the investigation and audiological examination hyperacusis subjective symptom questionnaire. Chinese version of hyperacusis questionnaire with reliability and validity, which can be applied to clinical quantitative evaluation of hyperacusis on patients life. The effects of distortion product otoacoustic emission auditory evaluation allergic cochlear function.

【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R764.45

【參考文獻】

相關(guān)期刊論文 前4條

1 連蕾;李玉茹;車勇軍;;耳鳴與畸變產(chǎn)物耳聲發(fā)射關(guān)系的研究概況[J];哈爾濱醫(yī)科大學學報;2012年02期

2 裴宏恩;響度重振現(xiàn)象[J];海軍總醫(yī)院學報;1999年03期

3 David JIANG;李剛;賴琳玲;;恐聲癥:鑒別和患病率[J];中國聽力語言康復科學雜志;2008年06期

4 刁明芳;孫建軍;;聽覺過敏[J];聽力學及言語疾病雜志;2009年06期

本文編號：1394329