自动听性脑干反应在新生儿缺氧缺血性脑病的相关因素的研究

Study on the Related Factors of Automatic Auditory Brainstem Response in Neonates with Hypoxic Ischemic Encephalopathy

目的:探讨新生儿缺氧缺血性脑病(HIE)患儿采用自动听性脑干反应(AABR)进行听力筛查的有效性。方法:选取本院2016年1月-2017年12月收治的75例HIE患儿,均行自动听性脑干反应检测和瞬态耳声发射(TEOAE)听力筛查,观察AABR和TEOAE听力障碍筛查结果。结果:75例患者,共150耳,TEOAE筛查中32例44耳(29.33%)未通过;32例TEOAE筛查未通过患儿中,未通过AABR患儿10例(31.25%)16耳;43例通过TEOAE检查的患儿中,AABR检查2例(4.7%)3耳未通过;150耳中,用AABR筛查通过率为87.3%,高于TAOAE筛查的通过率68.7%,差异有统计学意义(P<0.05);重度者听力筛查阳性率高于轻中度者,比较差异有统计学意义(P<0.05)。结论:AABR对HIE患儿听力筛查有较好的敏感性,可减少漏诊和误诊现象。随着患儿缺氧缺血性脑病的严重程度加重,AABR检查阳性率逐渐增加,因此,早期筛查能有效预防听力损害造成的语言发育障碍。

Objective： To investigate the effectiveness of automatic auditory brainstem response （ AABR ） for hearing screening in neonates with hypoxic ischemic encephalopathy （ HIE ） .Method： From January 2016 to December 2017, 75 children with HIE admitted in our hospital were selected as study objects.All the patients were examined by AABR test and TEOAE screening to observe the hearing disorder condition.Result： Among 75 cases 150 ears, there were 32 cases 44 ears （ 29.33% ） did not pass the TEOAE screening, from which 10 cases 16 ears did not pass AABR screening （ 31.25% ） .From 43 cases who passes the TEOAE screening, there were 2 caces （4.7%）3 ears did not pass the AABR test.The screening positive rate of AABR was 87.3%, higher than that of the TAOAE （ 68.7% ）, the difference was statistic significant （ P〈0.05 ） ; the positive rate of severe patients was higher than that of mild patients and moderate patients, the difference was statistic significant （ P〈0.05 ） . Conclusion： AABR has a good sensitivity to the hearing screening in children with HIE, which can reduce the misdiagnosis and missed diagnosis.With the aggravation of the hypoxic ischemic encephalopathy （ HIE ） severity in children, the positive rate increases gradually.Therefore, early screening should be carried out to effectively prevent the language developmental disorder caused by hearing impairment.