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目的:探讨耳声发射和听性脑干反应在先天性巨细胞病毒感染新生儿听力筛查中的临床可行性和效果。方法:选择2012年12月—2013年7月在本院出生,并诊断为先天性巨细胞病毒感染并接受新生儿听力初筛和复筛的新生儿48例为观察组,同期在我院产科分娩的足月新生儿50例为对照组,听力筛查分为出生后(2~3)天为初筛,出生后42天为复筛,两阶段筛查初筛采用瞬态声诱发耳声发射(TEOAE),复筛采用瞬态声诱发耳声发射(TEOAE)、畸变产物耳声发射(DPOAE)和听性脑干反应(ABR)共同筛查,复筛未通过者,于生后3个月再次来院进行筛查。结果:观察组48例(96耳),初筛通过82耳(通过率85.4%);对照组50例(100耳),初筛通过95耳(通过率95.5%),两组差异有统计学意义(2=5.138,P<0.05)。复筛时观察组48例(96耳),复筛TEOAE通过85耳(通过率88.5%);复筛DPOAE通过83耳(通过率86.5%);复筛ABR通过82耳(通过率85.4%);对照组49例,其中1例未来复筛(98耳),复筛TEOAE通过96耳(通过率98.0%);复筛DPOAE通过98耳(通过率100%);复筛ABR通过98耳(通过率100%);两组差异在TEOAE、DPOAE、ABR均有统计学意义(依次2=6.879,P<0.01;2=14.223,P<0.01;2=15.403,P<0.01)。结论:先天性巨细胞病毒感染新生儿听力障碍发生率明显高于对照组,此类患儿进行听力两阶段筛查非常重要,临床上应给予高度重视。
Objective: To investigate the clinical feasibility and effect of otoacoustic emissions and auditory brainstem response in hearing screening of neonates with congenital cytomegalovirus infection. Methods: Forty-eight neonates born in our hospital from December 2012 to July 2013 who were diagnosed as congenital cytomegalovirus infection and received neonatal hearing screening and re-screening were selected as the observation group. During the same period, 50 cases of full-term newborns of childbirth as the control group, hearing screening divided into postnatal (2 ~ 3) days for the first screening, 42 days after birth for the second screening, two-stage screening using transient acoustic evoked otoacoustic TEOAE, TEOAE, DPOAE and ABR were screened, and those who failed to pass the screening were screened out after birth 3 Month again to hospital for screening. Results: The observation group had 48 ears (96 ears), the first screening passed 82 ears (passing rate 85.4%), the control group of 50 ears (100 ears), the first screening passed 95 ears (passing rate 95.5%), the difference between the two groups was statistically Significance ( 2 = 5.138, P <0.05). 48 cases (96 ears) in re-screening group, TEOAE in 85 ears (passage rate 88.5%), DPOAE in 83 ears (passage rate 86.5% ; Control group of 49 cases, including 1 case of future screening (98 ears), TEOAE re-screening through 96 ears (passage rate of 98.0%); DPOAE screening through 98 ears (passage rate of 100% Pass rate 100%). There was significant difference between the two groups in TEOAE, DPOAE and ABR (2 = 6.879, P <0.01; 2 = 14.223, P <0.01; 2 = 15.403, P <0.01). Conclusion: The incidence of neonatal hearing impairment in congenital cytomegalovirus infection was significantly higher than that in control group. It is very important for these children to carry out two-stage hearing screening and should be given high priority in clinic.