高危新生儿听力损伤特征:194例分析

Characteristics of hearing loss in high-risk neonates: analysis of 194 cases

目的比较高胆红素血症、缺氧缺血性脑病、低出生体质量新生儿听力损伤发生情况,为早期治疗干预提供依据。方法将194例(388耳)新生儿分为高胆红素血症组、缺氧缺血性脑病组、低出生体质量儿组,对每组患儿予听性脑干诱发电位(auditorybrainstemresponse,ABR)检测。结果各组新生儿ABR总的反应阈为(53.65±18.38)dBnHL,总的异常率为43.0%,其中,低出生体质量组ABR的平均反应阈、异常率和重度异常率较高胆红素血症组和缺氧缺血性脑病组相比明显增高,高胆红素血症组的平均反应阈及重度异常率亦比缺氧缺血性脑病组明显增高。结论3种高危因素中,低出生体质量新生儿发生听力损伤的几率较大,程度也较重。此外,高胆红素血症新生儿的听力损害程度也比缺氧缺血性脑病新生儿重。故对高危新生儿应早期应用ABR进行听力筛选并及时干预。

AIM:To compare the occurrence of hearing loss in neonate with hyperbilirubinemia and hypoxic ischemic encepholopathy(HIE) and low birth body mass,so as to provide evidence for early intervention. METHODS:Totally 194 high risk neonates (388 ears) were divided into three groups:hyperbilirubinemia group,HIE group and low birth body mass group.Auditory brainstem response(ABR) was detected in all groups. RESULTS:The hearing threshold of ABR in all high risk neonates was(53.65±18.38) dBnHL,the total abnormal rate was 43.0%.The mean hearing threshold of ABR, abnormal rate and severe abnormal rate in the low birth body mass group were obviously increased as compared with those in the hyperbilirubinemia and HIE groups,and the mean hearing threshold of ABR and the abnormal rate in the hyperbilirubinemia group were much higher than those in the HIE group. CONCLUSION:Of the 3 high risk factors,hearing loss occurs more often and more serious in neonates with low birth body mass.Besides,neonates with hyperbilirubinemia have more serious hearing loss than those with HIE.So high risk neonates should receive hearing screening with ABR and be treated in time or followed up as early as possible.