新生儿多种听损伤高危因素共存时的听性脑干反应特征分析

Characteristics of hearing loss in 299 high-risk neonates

目的 探讨新生儿高胆红素血症与缺氧缺血性脑病(hypoxic ischemicencephalopathy,HIE)、极低出生体重(verylow birthweight,VLBW)分别或同时存在时的听性脑干反应(auditorybrainstemresponse,ABR)特点,为早期治疗干预提供参考。方法 299例(598耳)高危新生儿分为单纯高胆红素血症组、单纯HIE组、高胆红素血症+HIE组、高胆红素血症+VLBW组、HIE+VLBW组、高胆红素血症+VLBW+HIE6组,对每组患儿予ABR检测。结果 当新生儿高胆红素血症与HIE、VLBW三种高危因素同时存在时,其异常发生率、重度异常发生率、平均反应阈均较单纯高胆红素血症和单纯HIE显著提高,异常耳中的ABR各波缺失率、反应阈增高的发生率同样亦存在显著增高的现象。结论 当新生儿高胆红素血症与缺氧缺血性脑病、极低出生体重同时存在时,听损伤的几率相应增加,听损伤的程度也随之加重。此类患儿更应列为及早干预、重点随访的对象。

Objective To compare the occurrence of hearing loss in neonates with hyperbilirubinemia, hypoxic-ischemic encepholopathy (HIE) and very low-brith weight infant (VLBW) body mass, and to provide evidence for early intervention. Methods Totally 299 high-risk neonates (598 ears) were divided into six groups: pure hyperbilirubinemia group, pure HIE group, hyperbilirubinemia with HIE group, hyperbilirubinemia with VLBW group, HIE with LBWI group,hyperbilirubinemia with VLBW and HIE mass group. Auditory brainstem response (ABR) was detected in all groups. Results The hearing threshold of ABR and the abnormal rate of hyperbilirubinemia with LBWI and HIE were much higher than that of pure hyperbilirubinemia and pure HIE neonates. Conclusions Of the three high-risk factors, hearing loss occurs more often and more serious in neonates with hyperbilirubinemia and with VLBW while as HIE body mass. So the babies should receive hearing screening with ABR and be treated in time or following up as early as possible.