摘要
目的：分析高胆红素血症患儿治疗后的听力随访结果。方法573例高胆红素血症患儿（观察组）按黄疸干预方法分为换血组（67例，血清胆红素浓度344．2～1107．2μmol/L ，平均457．9μmol/L ）和光疗组（506例，血清胆红素浓度205．2～572．6μmol/L ，平均285．2μmol/L ），分别进行听力初筛、复筛，复筛未通过者于3月龄内进行听力学诊断，听力异常者采用听性脑干反应、畸变产物耳声发射和声导抗等进行听力检测，听力随访至24月龄，比较两组听力损失情况，并与836例正常新生儿（对照组）比较。结果3月龄听力学诊断时观察组听力损失发生率为5．76％（33/573），对照组为0．72％（6/836）；随访至24月龄时，观察组听力损失发生率（3．49％，20/573）高于对照组（0．24％，2/836），差异有统计学意义（ P＜0．05），换血组听力损失发生率（25．37％，17/67）高于光疗组（0．59％，3/506），差异有统计学意义（ P＜0．05），观察组中听力损失者主要表现为双侧极重度聋（80％，16/20）和蜗后病变（65％，13/20）。结论高胆红素血症患儿需换血治疗者更易发生听力损失，且以双侧极重度聋和蜗后病变为主，多为不可逆性改变。
Objective To share the analysis results of follow -up after treatment of hyperbilirubinemia hear-ing .Methods 573 cases of neonatal hyperbilirubinemia by jaundice intervention method was divided into exchange transfusion group （67 cases ,bilirubin concentration range of 344 .2-1 107 .2 μmol/L ,457 .9 μmol/L on average） and therapy group （506 cases ,bilirubin concentration in the range of 205 .2~ 572 .6 μmol/L ,average 285 .2 μmol/L） .The auditory brainstem response ,distortion product otoacoustic emission hearing detection and immittance method were used .The two groups of hearing loss were compared with 836 cases of normal controls .Results The observation group showed that hearing disorder morbidity rate was 3 .49% （20/573） ,for the control group ,the hearing loss morbidity rate was 0 .24% （2/836） .There was a statistically significant difference between the two groups （P〈0 .05） .For the exchange transfusion group ,hearing losses accounted for 25 .37% of the overall change （17/67） .For the phototherapy group ,the hearing losses accounted for 0 .59% of the overall （3/506） phototherapy , showing statistically significant difference between the two groups （P〈0 .05） .There were hearing impairment with bilateral severe （80% ,16/20） and retrocochlear lesions （65% ,13/20） .Conclusion The bilirubin concentration in blood transfusion for the children tended to have hearing impairment ,more in bilateral severe and retrocochlear le-sions ,hearing loss was irreversible .
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2014年第3期235-238,共4页
Journal of Audiology and Speech Pathology
基金
卫生行业科研专项项目(201202005)
广西柳州市应用技术研究与开发计划课题2010030732
关键词
胆红素浓度
高胆红素血症
听力损失
听力监测
干预
Bilirubin levels
Hyperbilirubinemia
Hearing loss
Hearing monitoring
Intervention
