新生儿缺氧缺血性脑病90例听力筛查分析

Analysis of hearing screening for 90 cases suffered neonatal hypoxic-ischemic encephalopathy

【目的】 探讨新生儿缺氧缺血性脑病 (HIE)对听力的影响程度。 【方法】 采用瞬态耳声发射仪(TEOAE)分别对HIE儿和正常儿进行听力筛查 ,对于TEOAE不通过者 ,动态观察一定时间后用ABR听觉脑干诱发电位TIP 3 0 0型电反应测听仪进行诊断性测定。同时用 χ2 检验比较其TEOAE通过率 ,以及HIE儿的临床分度、NBNA、单项格格声、CT检查等与TEOAE结果的关系。 【结果】 正常儿与HIE儿TEOAE通过率在 7d ,42d ,3个月差异均有显著性 ,不同临床程度的HIE儿之间差异也有显著性 ,但是HIE儿TEOAE通过率与CT分度不一致 ,与单项格格声反应分度不一致。 【结论】 HIE对听力损伤明显 ,恢复较慢 ,应定期筛查 ,动态观察 ,适当延长治疗干预时间 ,ABR与TEOAE并用监测HIE可对蜗后性听力损失检出。HIE儿生后 7～ 42d均可作为听力筛查时间 ;而正常儿则在 42d筛查为最佳时间。

To explore the effect of neonatal hypoxic ischemic encephalopathy(HIE) on hearing ability. With TEOAE hearing ability was selected and checked for HIE baby and normal baby respectively.The failure of TEOAE would be given an diagnosis test by auditory brainstem response (ABR,TIP 300)after certain period of dynamic observation.Meanwhile,χ 2 test was used to inspect and compare the passing rate of TEOAE as well as the clinical grades ,NBNA,monomial cluck and CT examination of HIE baby,which connected with TEOAE. The passing rates of TEOAE between normal baby and HIE baby had conspicuous differences at 7th day ,42nd day and 3rd month.HIE babies of different clinical grades also had great differences,but the TEOAE passing rate of HIE babies was inconsistent with CT grades and monomial cluck. [Conclusions] HIE has evident damage on hearing,which makes patients a slow recovery.Patients should be selected and checked regularly,given dynamic observation and properly prolonged for treatment and intervation.Post cochlear hearing damage of HIE baby can be examined with ABR and TEOAE simultaneously.In hearing test,the 7th to 42nd day after birth for HIE babies and the 42nd day for normal babies can be regarded as the best time for screening examination.