梁玲芳毕业论文.doc

·中文论著摘要· 巨细胞病毒感染致婴儿听力受损的早期干预后随访 目的 观察婴儿期巨细胞病毒(CMV)感染后脑干听觉诱发电位(BAEP)的变化及对于早期以更昔洛韦为主综合治疗后患儿的听力情况的随访。2008年3月至2008年12月入住我科的45例BAEP有异常改变的CMV感染患儿选取45例听力异常的巨细胞病毒感染婴儿，分析其脑干听觉诱发电位的特点，给予更昔洛韦抗病毒、营养脑细胞及听觉刺激法等早期综合干预方案，随后作4-6个月的疗效随访，以观察治疗后听力是否恢复及具体恢复情况。双耳出现异常的为35例（77.8%），单耳出现异常的为10例（22.2%）；仅客观听阈轻度增高的有28例（62.2%），客观听阈轻度增高伴有波的异常改变的有5例（11.1%），仅客观听阈中重度增高的有1例（2.2%），客观听阈中重度增高伴有波的异常改变的有11例（24.4%），未发现有客观听阈正常而波有异常改变的病例。更昔洛韦等早期干预治疗后随访4～6个月时，除4例失访外，治愈（BAEP恢复正常）36例(87.8 %)，有效4例（9.8%），无效1例（2.4%），总有效率97.6%。CMV感染可引起婴儿不同程度的听力受损，最常表现为客观听阈轻度增高，其次为客观听阈中重度增高伴有波的改变，再次仅有客观听阈中重度增高不伴有波的改变。更昔洛韦为主的早期综合干预，对CMV 感染引起的婴儿听力损害的疗效满意、安全，临床值得推广。巨细胞病毒感染; 听力受损; 脑干听觉诱发电位; 更昔洛韦; 早期干预 Initially Investigation of Early Intervention Therapy of the Hearing Impairment Due to Cytomegalovirus Infection in Infants Objective To explore the change of brainstem auditory evoked potential (BAEP) and to investigate the curative effect of the early intervention therapy mainly combining with Ganciclove on the hearing impairment resulted from Cytomegalovirus (CMV) infection in infants. Methods BAEP were performed in 45 infants with CMV infection to screen and evaluate the hearing ability, recording the early intervention therapy combining with Ganciclove, nutrition of brain cell, stimulating sense of hearing and so on. Then we observed the effect of treatment after 4-6 months follow-up. Result Abnormal for both ears of 35 cases (77.8%), Abnormal for one ear of 10 cases (22.2%), Only mildly higher objective hearing threshold of 28 cases (62.2%), mildly higher objective hearing threshold with abnormal waves were 5 cases (11.1%), only objective hearing thresholds of moderate to severe increased were 1 case (2.2%), objective hearing threshold increased with moderate to severe with abnormal waves were 11 cases (24.4%). Not found to have normal objective hearing thresholds with the wave of cases of abnormal changes. After therapy termination and then 4～6 months later, BAEP were investigated, 36 cases (87.8 %) turn to normal, 4 cases