發(fā)布時(shí)間：2018-12-28 06:55

【摘要】：目的了解聽(tīng)力正常與聽(tīng)力下降耳鳴患者心理問(wèn)題及心理聲學(xué)特點(diǎn),為耳鳴的個(gè)性化診治提供依據(jù)。 方法將613名患者分為2組：聽(tīng)力正常組和聽(tīng)力下降組。分別進(jìn)行純音聽(tīng)閾、耳鳴測(cè)定檢查,并填寫(xiě)耳鳴殘疾度量化表(THI)、焦慮自評(píng)量表(SAS)、抑郁自評(píng)量表(SDS)。 結(jié)果年齡60歲并伴聽(tīng)力損失的耳鳴患者所占比例最高；聽(tīng)力正常與聽(tīng)力下降組耳鳴患者的年齡構(gòu)成差異有統(tǒng)計(jì)學(xué)意義(P0.05),聽(tīng)力下降組耳鳴患者年齡構(gòu)成較聽(tīng)力正常組偏老齡化；聽(tīng)力正常與聽(tīng)力下降耳鳴患者耳鳴嚴(yán)重程度差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；聽(tīng)力正常組耳鳴患者耳鳴響度較聽(tīng)力下降組耳鳴響度大；聽(tīng)力正常組較聽(tīng)力下降組耳鳴患者殘余抑制時(shí)間長(zhǎng)。兩組耳鳴患者佛德曼曲線類型差異有統(tǒng)計(jì)學(xué)意義,且兩組匯聚型和重疊型所占比例差異也有統(tǒng)計(jì)學(xué)意義(P0.05),聽(tīng)力正常組佛德曼曲線重疊型所占比例高于聽(tīng)力下降組。聽(tīng)力正常組耳鳴患者焦慮情緒陽(yáng)性率高于聽(tīng)力下降組,聽(tīng)力下降組耳鳴患者抑郁情緒陽(yáng)性率高于聽(tīng)力正常組。 結(jié)論聽(tīng)力損失與年齡是耳鳴的重要相關(guān)因素；耳鳴的嚴(yán)重程度與聽(tīng)力損失情況無(wú)關(guān),耳鳴對(duì)情緒、睡眠、工作的影響是心理問(wèn)題,必須重視耳鳴心理治療；聽(tīng)力正常耳鳴患者焦慮癥狀陽(yáng)性率比抑郁癥狀陽(yáng)性率高,而聽(tīng)力下降耳鳴患者抑郁癥狀陽(yáng)性率較焦慮癥狀陽(yáng)性率高；聽(tīng)力正常與聽(tīng)力下降患者的耳鳴響度、殘余抑制時(shí)間和佛德曼曲線類型存在差異,聽(tīng)力正常耳鳴患者的掩蔽效果優(yōu)于聽(tīng)力下降者。這些結(jié)論對(duì)耳鳴治療方案的選擇有指導(dǎo)性意義。
[Abstract]:Objective to investigate the psychological problems and psychoacoustic characteristics of patients with normal hearing and hearing loss tinnitus so as to provide basis for individualized diagnosis and treatment of tinnitus. Methods 613 patients were divided into two groups: normal hearing group and hearing loss group. The pure tone hearing threshold and tinnitus were measured, and the quantitative scale of tinnitus disability was filled out. (THI), anxiety scale, (SAS), self rating scale, (SAS), depression scale, self-rating scale (SDS). Results the proportion of tinnitus patients aged 60 years with hearing loss was the highest. The age composition of tinnitus patients in normal hearing group and hearing loss group was significantly different (P0.05). The age composition of tinnitus patients in hearing loss group was older than that in normal hearing group. There was no significant difference in the severity of tinnitus between normal hearing group and hearing loss tinnitus group (P0.05); the tinnitus degree of hearing normal group was larger than that of hearing loss group. The residual inhibition time of tinnitus patients in normal hearing group was longer than that in hearing loss group. There were significant differences between the two groups of tinnitus patients in the type of Friedman curve and the proportion of convergent type and overlap type (P0.05). The proportion of Fedman curve overlap type in normal hearing group was higher than that in hearing loss group. The positive rate of anxiety in normal hearing group was higher than that in hearing loss group, and the positive rate of depression in hearing loss group was higher than that in hearing normal group. Conclusion hearing loss and age are important related factors of tinnitus, and the severity of tinnitus is not related to hearing loss. The effects of tinnitus on mood, sleep and work are psychological problems, so we must pay attention to the psychotherapy of tinnitus. The positive rate of anxiety symptoms in hearing normal tinnitus patients was higher than that of depression symptoms, while the positive rate of depressive symptoms in hearing loss tinnitus patients was higher than that of anxiety symptoms. There were differences in tinnitus loudness residual inhibition time and Friedman curve between normal hearing and hearing impaired patients. The masking effect of hearing normal tinnitus patients was better than that of hearing loss patients. These conclusions are instructive to the choice of tinnitus treatment.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R764

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