婴幼儿化脓性脑膜炎听力损失及转归特点分析

Analysis of hearing loss in infants with purulent meningitis

目的探讨婴幼儿化脓性脑膜炎导致听力下降情况及听力下降的转归情况。方法回顾性分析自2012年7月至2013年3月我院收治的化脓性脑膜炎患儿66例,全部患儿行脑干测听检查。同时回顾性分析了患儿的影像学检查,如颞骨CT,头部核磁,增强核磁等。听力异常者三个月到半年复查脑干测听检查。结果入组的化脓性脑膜炎患儿66例,30例患儿出现听力下降(45.5%),其中21例患儿进行了听力学随访,共10例(47.6%)患儿听力下降未恢复或未完全恢复。此21例患儿中轻度听力下降3例,随访听力全部恢复正常;中度及中重度听力下降9例,7人恢复正常,2人听力未恢复;重度及极重度听力下降9人,1人听力恢复,2人听力部分恢复,余6人听力未恢复。结论化脓性脑膜炎对婴幼儿听力影响明显;合并听力下降的程度与听力损失恢复程度明显相关,轻度听力下降听力多可恢复,听力下降程度较重,则可能导致永久性听力损失。

Objective To investigate hearing loss and treatment outcomes in infants with purulent meningitis. Methods Data from 66 patients with purulent meningitis from June 2012 to March 2013 were analyzed,including temporal bone CT, head MRI and enhanced MRI scans. For patients with hearing loss, hearing levels were rechecked 3 to 6 months later. Result Auditory brainstem response（ABR） examinations were performed in all patients and demonstrated hearing loss in 30 patients. Follow-up was completed in 21 of the 30 patients,with 10 showing no hearing loss recovery. Hearing loss was mild in 3 cases（all showing recovery to normal）,moderate and moderate-severe in 9 cases（with 7 showing recovery）, and severe in 9 cases（with only 1 showing complete and 2 showing partial recovery）. Conclusions The effect of purulent meningitis on hearing in infants is significant. Mild hearing loss may recover, while moderate and severe hearing loss may last a lifetime.