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[某钢铁企业爆炸事故中受伤人员爆震性聋的回顾性调查]

[Retrospective investigation on explosive hearing loss of injured persons in explosion accidents involving a steel enterprise].

作者信息

Chen G S, Zhang H L, Liu R Z, Gu G Z, Yu S F

机构信息

Wugang Institute of Occupational Disease Prevention and Control, Wugang 462500, China.

General Hospital of Wugang Company, Wugang 462500, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Feb 20;38(2):132-136. doi: 10.3760/cma.j.issn.1001-9391.2020.02.012.

DOI:10.3760/cma.j.issn.1001-9391.2020.02.012
PMID:32306678
Abstract

Through the investigation of the injured persons in explosion accidents, the impact of wearing the ear protectors device (anti-noise earplugs) on the auditory organs and hearing loss of the injured person was understood, which could provide reference for the clinical diagnosis, treatment and prevention of the explosive hearing impairment. A retrospective survey was conducted on 39 directly injured persons who were injured in 23 explosion accidents involving a steel plant from 1990 to 2016 as the explosive hearing loss, taking the time of the patient's injury and 3-6 months after the injury as the time of investigation and evidence collection, and according to whether to wear the ear protectors device for group comparison and statistical analysis. There was no significant difference between the two groups in hearing loss, tinnitus, earache, headache, some patients with dizziness and craniocerebral injury, regardless of whether the injured person wore anti-noise earplugs or not (=0.444-1) , the shock (coma) patients in the non-protected group were more common (34.8%, 8/23) , and the difference was statistically significant (=0.012) ; Although auricle injury was detected in both groups and there was no significant difference between the two groups (=1) , but the external ear canal injury, tympanic membrane perforation were more common in the non-protected group, and there was no external ear canal and tympanic membrane perforation in the wearing earplug group, and the difference between the two groups was significant (=0.000) . After 3-6 months, the rehabilitation of auditory system and other symptoms in patients showed that the hearing loss, tinnitus, earache, headache, dizziness and other symptoms all disappeared in patients wearing earplugs, while the above symptoms in the non-protected group were improved but more persisted, and the difference between the two groups was statistically significant (=0.000-0.012) , and there was no significant difference in rehabilitation conditions such as craniocerebral injury between the two groups (=1) ; There were patients with unhealed auricle injury in both groups in 3-6 months after the injury, and there was no significant difference between the two groups (=1) , however, in the non-protected group, 69.57% (16/23) of the patients with external auditory canal injury were still unhealed and none of the patients with tympanic membrane perforation recovered, and the difference between the two groups was obvious (=0.000~0.001) ; Pure tone air conduction examination showed that the hearing of the earplugs wearers was well recovered at the time of the explosion, while irreversible hearing impairment was common in the non-protective group, the difference was statistically significant (=0.000) . Ear protector plays an important role in protecting the auditory organs and hearing of workers in explosion accident, and it is an effective protective measure to prevent and reduce the damage of external ear canal, perforation of tympanic membrane and explosive hearing loss caused by explosion accidents.

摘要

通过对爆炸事故中受伤人员的调查,了解佩戴耳部防护装置(抗噪耳塞)对伤者听觉器官及听力损失的影响,可为爆震性听力损伤的临床诊断、治疗及预防提供参考。对1990年至2016年某钢铁厂23起爆炸事故中的39名直接受伤人员进行回顾性调查,以患者受伤时及伤后3 - 6个月作为调查取证时间,按是否佩戴耳部防护装置进行分组对比及统计分析。听力损失、耳鸣、耳痛、头痛、部分伴有头晕及颅脑损伤的患者,两组间差异无统计学意义(=0.444 - 1),未佩戴防护耳塞组的休克(昏迷)患者更为常见(34.8%,8/23),差异有统计学意义(=0.012);两组均检出耳廓损伤,且两组间差异无统计学意义(=1),但未佩戴组外耳道损伤、鼓膜穿孔更为常见,佩戴耳塞组未出现外耳道及鼓膜穿孔,两组间差异有统计学意义(=0.000)。伤后3 - 6个月患者听觉系统及其他症状恢复情况显示,佩戴耳塞患者听力损失、耳鸣、耳痛、头痛、头晕等症状均消失,未佩戴组上述症状虽有改善但仍多有残留,两组间差异有统计学意义(=0.000 - 0.012),两组颅脑损伤等恢复情况差异无统计学意义(=1);伤后3 - 6个月两组均有耳廓损伤未愈合患者,两组间差异无统计学意义(=1),然而,未佩戴组外耳道损伤患者仍有69.57%(16/23)未愈合,鼓膜穿孔患者无一恢复,两组间差异明显(=0.000~0.001);纯音气导检查显示,爆炸时佩戴耳塞者听力恢复良好,未佩戴组则常见不可逆性听力损伤,差异有统计学意义(=0.000)。耳部防护装置对爆炸事故中作业人员的听觉器官及听力具有重要保护作用,是预防和减少爆炸事故所致外耳道损伤、鼓膜穿孔及爆震性听力损失的有效防护措施。

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