摘要
目的探讨新生儿高胆红素血症对婴幼儿期听力及学龄前发育的影响。方法选择2012年8月至2016年11月出生的138例高胆红素血症患儿作观察组,根据总胆红素(TBIL)水平分轻度组(220.6~270.6μmol/L)41例,82耳;中度组(270.6~320.6μmol/L)49例,98耳;重度组(>320.6μmol/L)48例,96耳。其中117例患儿根据治疗前高胆红素维持时间分1天组(072h)31例,62耳。其中95例患儿参与丹佛发育筛查量表问卷(DDST)调查,进行学龄前发育情况随访(随访时年龄4~6岁)。随机选择同期足月产正常新生儿42例作对照组。各组出生后第3天行瞬态声诱发耳声发射(TEOAE),3、6个月行畸变产物耳声发射(DPOAE)、听觉脑干诱发电位(ABR)、声阻抗检查。结果轻、中度组与对照组婴幼儿期听力无显著差异(P>0.05),重度组与对照组有显著差异(P<0.05)。轻、中度组出生后第3天、出生后3个月、出生后6个月听力无显著差异(P>0.05),重度组有显著差异(P<0.05)。治疗前不同血清高胆红素维持时间组婴幼儿期听力无显著差异(P>0.05)。轻、中度组与重度组学龄前随访结果有显著差异(P<0.05)。结论治疗前血清高胆红素维持时间对婴幼儿期听力无影响,重度高胆红素血症对婴幼儿期听力及学龄前发育有影响。
Objective To report effects of neonatal hyperbilirubinemia on hearing in infancy and development in preschool children. Methods One hundred thirty-eight neonates with hyperbilirubinemia who were born from August2012 to November 2016 were studied and divided into three groups based on total bilirubin levels, i.e. mild(220.6-270.6μmol/L, n=41), moderate(270.6-320.6 μmol/L, n=49) and severe(>320.6 μmol/L, n=48). In 117 newborns, hyperbilirubinemia lasted 1 day(n=30), 2 days(n=30), 3 days(n=26) or 4 days(n=31) before treatment. The Denver Development Screen Test(DDST) was administered in 95 children to survey development status at 4 to 6 years of age. Forty-two full term normal neonates were randomly selected to serve as the control group. In all newborns, transient evoked otoacoustic emissions(TEOAEs) were tested on day 3, and distortion product otoacoustic emissions(DPOAEs), auditory brainstem responses(ABRs) and acoustic impedance were performed in the first 3 and 6 months after birth. Results Hearing screening results were not significantly different between children with mild, moderate or severe hyperbilirubinemia and the control group(P>0.05), nor among children with different durations of hyperbilirubinemia before treatment(P>0.05). Hearing showed no significant difference at 3 days, 3 months or 6 months in children with mild or moderate hyperbilirubinemia(P>0.05), but showed significant difference in those with severe bilirubinemia(P<0.05). Development during preschool years was significantly different between children with mild or moderate bilirubinemia and those with severe bilirubinemia(P<0.05). Conclusion The duration of hyperbilirubinemia before treatment has no effect on hearing in infancy. Severe hyperbilirubinemia can affect hearing in infancy and development in preschool children.
作者
曾超军
林少莲
林昶
ZENG Chaojun;LIN Shaolian;LIN Chang(Department of Otolaryngology Head and Neck Surgery,First Hospital of Putian City,Putian,351100,China;Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of Fujian Medical University,Fujian,350005,China.)
出处
《中华耳科学杂志》
CSCD
北大核心
2020年第1期68-73,共6页
Chinese Journal of Otology
基金
福建省医学创新课题(2016-CX-28)~~
关键词
高胆红素血症
听力
发育
Hyperbilirubinemia
Hearing
Development
