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目的:探讨脑外伤后伴发听力损伤的患者听性脑干反应的特点及其和预后的相关性。方法:纳入颅脑外伤伴发听力障碍的患者50例,其中男34例,女16例,为观察组,选健康正常成年人50例为对照组,其中男30例,女20例。对观察组受伤后2周内及6个月后进行听性脑干反应检查,对比分析两组患者听性脑干反应波特点及其和预后的相关性。结果:正常人听觉阈值的95%置信区间是[10.24-19.33]d BHL。观察组和对照组的听觉阈值分别为52.24±21.75(d Bn HL)、11.36±3.02(d Bn HL),差异有统计学意义(p<0.05)。对照组主波Ⅰ、Ⅲ、Ⅴ出现率为100%,观察组的出现率分别为78.00%、66.00%、88.00%,差异有统计学意义(P<0.05)。病例组和对照组相比,Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ潜伏期均延长,差异存在统计学意义(P<0.05)。预后良好组患者受伤2周内和6个月后Ⅰ、Ⅲ、Ⅴ出现率明显增加,潜伏期缩小,差异有统计学意义(P<0.05)。而无改善组患者Ⅰ、Ⅲ、Ⅴ出现率略有增加,潜伏期缩小不明显,差异无统计学意义(P>0.05)。结论:脑外伤患者听性脑干反应主波Ⅰ、Ⅲ、Ⅴ缺失,潜伏期缩小,若此种变化持续不改善,预示着听力损伤预后较差。
Objective: To investigate the characteristics of auditory brainstem response in patients with hearing impairment after traumatic brain injury and its correlation with prognosis. Methods: Fifty patients with craniocerebral trauma accompanied by hearing loss were enrolled, including 34 males and 16 females. The observation group included 50 normal healthy adults as control group, including 30 males and 20 females. The auditory brainstem response was observed within 2 weeks and 6 months after injury in the observation group. The correlation between the characteristics of auditory brainstem response and the prognosis of the two groups was analyzed. Results: The 95% confidence interval for normal human auditory threshold was [10.24-19.33] d BHL. The auditory thresholds of the observation group and the control group were 52.24 ± 21.75 (d Bn HL) and 11.36 ± 3.02 (d Bn HL), respectively. The difference was statistically significant (p <0.05). The incidence of main wave Ⅰ, Ⅲ and Ⅴ in the control group was 100%. The incidence of the observation group was 78.00%, 66.00% and 88.00%, respectively. The difference was statistically significant (P <0.05). Compared with the control group, the latency of Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ in the case group was longer than that in the control group, the difference was statistically significant (P <0.05). The prognosis of patients with good prognosis group within 2 weeks and 6 months after the occurrence of Ⅰ, Ⅲ, Ⅴ increased significantly, the incubation period decreased, the difference was statistically significant (P <0.05). The incidences of Ⅰ, Ⅲ and Ⅴ in the patients without improvement group increased slightly, but the latent period decreased insignificantly with no significant difference (P> 0.05). CONCLUSION: The main wave Ⅰ, Ⅲ and Ⅴ of auditory brainstem response in patients with traumatic brain injury are deficient and the incubation period is shortened. If these changes continue unabated, it indicates that the prognosis of hearing impairment is poor.