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纯音测听是主观测听,结果的准确性受诸多因素的影响,特别是受患者心理因素影响较大.本文探讨了患者心理因素对纯音测听结果的影响,以及纯音测听对非器质性听力损失诊断的可行性,现报告如下:1材料和方法1.1临床资料 主诉为听力损失的41例57耳中,因外伤者10例14耳,因受爆震者31例43耳;男37例,女4例;年龄为9～60岁,平均26.31岁.1.2方法 应用美国GSI—10型听力计在标准隔声室内按常规(上升法)进行,背景噪声符合ISO 8253—1(1989)规定要求.详询有关病史,注意掌握患者的就诊目的和心理状态,对病人的大致的听力情况做到心中有数,再按常规给患者做听力测试.在测试中注意病人的反应和表现,如对测试结果有怀疑,则针对情况给患者做好解释工作,并给患者以适当的暗示,取得患者的配合,耳做第二次,甚至多次测听,其间需让患者稍事休息,以免疲劳,直到认为获得真实听阈,结果准确并与客观病情相符合为止.1.3 结果判定 其标准为听力损失的平均阈值:每个频率(0.125、0.25、0.5、l、2、4和8kHz)均测试五次以上,其中取至少有三次以上能够重复的阈值为真实听阈,用其平均值做为听力损失的评估.2结果57耳中经过反复检测,阈值可以从异常变为正常者(<25 dB HL),占56.1%;听力确有损失但在首次测试中套大其损失10dB以上者,占40.35%
Pure tone audiometry is subjective listening, the accuracy of the results is affected by many factors, especially by the psychological factors of patients.This article discusses the psychological factors of patients on pure audiometry results, as well as pure tone audiometry non-organic The feasibility of diagnosis of sexual hearing loss, are reported as follows: 1 Materials and methods 1.1 Clinical data The main complaint was hearing loss in 41 cases of 57 ears, 10 cases of trauma due to 14 ears, due to detonation shock in 31 cases 43 ears; male 37 The age ranged from 9 to 60 years old, with an average of 26.31 years.1.2 Methods of application The American GSI-10 audiometer was operated according to the conventional method (ascending method) in a standard soundproof room with background noise in accordance with ISO 8253-1 (1989) Detailed requirements of the medical history, pay attention to grasp the purpose of the patient’s treatment and psychological state of the patient’s general hearing to be aware of, and then to the patient to do hearing tests in the test attention to patient response and performance, such as The test results have doubts, then the situation for the patient to explain the work, and to patients with the appropriate hints to obtain the patient’s cooperation, the ear to do the second, or even multiple audiometry, during which patients need to take a break, so as not to Fatigue until you think that you get a real hearing threshold , The results were accurate and consistent with the objective condition.1.3 The results were judged as the average hearing loss threshold: each frequency (0.125,0.25,0.5,1,2,4 and 8kHz) were tested more than five times, whichever is less There are three or more thresholds that can be repeated as the real hearing threshold, and the average value is used as the assessment of hearing loss.2 Results Fifty-seven (56.1%) of the thresholds can be changed from abnormal to normal (<25 dB HL) Hearing loss but in the first test set large loss of 10dB or more, accounting for 40.35%