重度高胆红素血症新生儿的听力损伤分析.docVIP

重度高胆红素血症新生儿的听力损伤分析 　　作者：陈健平，邓鹏，秦卫红，马钊，林希平 作者单位：1.广西柳州市人民医院，广西医科大学第五附属医院儿科，广西，柳州，545001;2.广西柳州市人民医院，广西医科大学第五附属医院耳鼻喉科，广西，柳州，545001 　　【摘要】目的 探讨重度高胆红素血症新生儿的听力损伤特点及其影响因素。方法 35例重度高胆红素血症新生儿根据临床是否实施换血治疗分为两组，A组(换血治疗)21例;B组(未换血治疗)14例，所有患儿予听性脑干诱发电位(ABR)检测，异常者于3个月后随访。结果 A组听反应阈为(57.14±19.91)dBnHL，B组为(63.93±20.97)dBnHL(P0.05)。两组ABR反应阈增高、ABR全波缺失及重度耳发生率的差异有显著性(P均0.05)。在90dBnHL短声刺激下，两组Ⅰ波潜伏期及Ⅰ～Ⅴ波间期异常的差异有显著性(P均0.05)。3个月后随访，两组ABR异常恢复率的差异有显著性(P0.05)。结论 换血患儿ABR发生异常程度轻于未换血患儿，且3个月后的恢复率亦好于未换血患儿。重度高胆红素血症患儿达到换血指征时，及早进行换血治疗能减轻听力损伤程度，有必要对重度高胆红素血症患儿进行早期的听力检测以及跟踪随访。 　　【关键词】 高胆红素血症 新生儿 听力受损者 诱发电位 听觉 脑干 　　A study of neonatal hearing loss induced by severe hyperbilirubinemia 　　CHEN Jian-ping, DENG Peng, QIN Wei-hong, MA Zhao, LIN Xi-ping 　　1. Department of Pediatrics, the Peoples Hospital of Liuzhou City, the Fifth Affiliated 　　Hospital of Guangxi Medical University, Liuzhou, Guangxi 545001, China; 　　2. Department of Otolaryngology, the Peoples Hospital of Liuzhou City, the Fifth 　　Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi 545001, China 　　Abstract: Objective To evaluate the characteristic pattern and risk factors of hearing loss in neonates with severe hyperbilirubinemia. Methods Auditory brain-stem response (ABR) was measured in 35 neonates with severe hyperbilirubinemia. They were assigned in group A (21 cases, receiving exchange transfusion treatment) and group B (14 cases, receiving no exchange transfusion treatment). Those hearing impaired neonates were rechecked via ABR after 3 months. Results In group A, the mean hearing threshold was (57.14±19.91)dBnHl, and group B was (63.93±20.97)dBnHL, there was no statistical difference (P0.05). The mean hearing threshold of ABR, full wave deletion of ABR and incidence of severe abnormality in group A were lower than those in group B (P0.05). In 90dBnHL short sound stimulation, the abnormality of wave Ⅰ and interpeak latencies Ⅰ～Ⅴ waves were significant differences (P0.05). A follow-up of 3 m