论文部分内容阅读
目的:了解高胆红素血症对早产儿听力的影响,探讨畸变产物耳声发射(DPOAE)检测技术用于高胆红素血症早产儿听力筛查中的可行性及临床意义。方法:对142例高胆红素血症早产儿(A组)及150例同期住院的血清胆红素正常的早产儿(B组)进行DPOAE测试,未能通过者42天后复查,仍不能通过者于生后3个月再次复查并行脑干诱发电位(ABR)检查。结果:A组ABR异常率高于B组(6.3%vs0.7%,P<0.01);血清总胆红素超过342μmol/L时ABR异常率明显高于≤342μmol/L组(17.6%vs2.7%,P<0.01);血清总胆红素≤342μmol/L时,与B组相比初筛通过率降低(80.6%vs91.7%,P<0.01),而3个月时ABR异常率与B组差异无统计学意义(2.7%vs0.7%,P>0.05)。结论:高胆红素血症可引起早产儿听力障碍,血清总胆红素超过342μmol/L时早产儿听力障碍发生率明显增加,血清总胆红素≤342μmol/L时听力损害是可逆的。DPOAE听力筛查方法快速、敏感、无创、简便易行,可作为筛查高胆红素血症早产儿听力障碍的基本方法。
Objective: To investigate the effect of hyperbilirubinemia on hearing loss in preterm infants and to explore the feasibility and clinical significance of using distortion product otoacoustic emissions (DPOAE) detection in hearing screening of premature infants with hyperbilirubinemia. Methods: DPOAE was tested in 142 cases of premature infants with hyperbilirubinemia (group A) and 150 cases of normal serum bilirubin in premature infants (group B). After failing to pass the examination for 42 days, they still failed to pass Three months after birth, again review the parallel brainstem response (ABR) examination. Results: Abnormal rate of ABR in group A was higher than that in group B (6.3% vs0.7%, P <0.01). Abnormal rate of ABR in group with serum total bilirubin exceeding 342μmol / L was significantly higher than that in group≤342μmol / L (17.6% vs2. 7%, P <0.01). When serum total bilirubin was less than or equal to 342 μmol / L, the rate of primary screening was lower than that of group B (80.6% vs91.7%, P <0.01) There was no significant difference with group B (2.7% vs0.7%, P> 0.05). CONCLUSION: Hyperbilirubinemia can cause hearing loss in premature infants. The prevalence of hearing impairment in preterm infants with serum total bilirubin more than 342 μmol / L is significantly increased. The hearing impairment is reversible when serum total bilirubin is less than or equal to 342 μmol / L. DPOAE hearing screening method is fast, sensitive, noninvasive and simple and can be used as a basic method for screening hearing loss in preterm children with hyperbilirubinemia.