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目的探讨新生儿重症监护病房患儿听力筛查情况并与母婴同室新生儿听力筛查情况进行比较。方法对927例新生儿重症监护病房患儿和16 353例母婴同室新生儿采用瞬态诱发耳声发射进行初筛和复筛,并对筛查阳性者进行诊断性听力学检测。结果 927例新生儿重症监护病房患儿中,通过筛查发现感音神经性听力障碍28例,其中高胆红素血症11例,极低体重儿9例,缺血缺氧性脑病6例,脑膜炎2例,检出率为3.02%(28/927);母婴同室听力筛查新生儿16 353例中,发现感音神经性听力障碍50例,检出率为0.31%(50/16 353),其中有宫内感染史23例,高胆红素血症12例,有耳聋家族史10例,脑膜炎病史3例,母亲孕期耳毒性药物使用史2例,二者差异有统计学意义(P<0.05)。结论新生儿重症监护病房患儿感音神经性听力障碍的检出率明显高于母婴同室新生儿;高胆红素血症、极低体重儿和缺氧缺血性脑病是新生儿重症监护病房患儿感音神经性听力障碍发生的主要高危因素;宫内感染、高胆红素血症及耳聋家族史是母婴同室新生儿感音神经性听力障碍发生的主要高危因素,应该强化对这部分新生儿听力筛查和干预工作。
Objective To investigate the hearing screening of children with neonatal intensive care unit and to compare with the hearing screening of neonates in the same room. Methods A total of 927 neonatal intensive care unit patients and 16 353 mothers and their newborns with the same room were subjected to initial screening and re-screening with transient evoked otoacoustic emissions. Diagnostic tests were performed on those with positive screening tests. Results Among 927 neonatal intensive care unit patients, 28 cases of sensorineural hearing impairment were found by screening, including 11 cases of hyperbilirubinemia, 9 cases of very low birth weight, 6 cases of hypoxic-ischemic encephalopathy , Meningitis in 2 cases, the detection rate was 3.02% (28/927); maternal and neonatal hearing screening of 16 353 newborns, 50 cases of sensorineural hearing loss were found, the detection rate was 0.31% (50 / 16 353), including 23 cases of intrauterine infection, 12 cases of hyperbilirubinemia, 10 cases of deafness family history, 3 cases of meningitis, mother’s history of ototoxic drug use in 2 cases, the difference was statistically Significance (P <0.05). Conclusions The detection rate of sensorineural hearing impairment in children with neonatal intensive care unit is significantly higher than that of neonatal maternal and neonatal ones; hyperbilirubinemia, very low birth weight children and hypoxic-ischemic encephalopathy are neonatal intensive care Ward children with sensorineural hearing loss of the main risk factors; intrauterine infection, hyperbilirubinemia and deafness family history of neonatal maternal and neonatal sensorineural hearing loss is the main risk factors should be strengthened This part of the neonatal hearing screening and intervention.