【摘要】：目的:本研究對(duì)小兒重度感音神經(jīng)性聽(tīng)力障礙蝸性病變和蝸后病變的多頻聽(tīng)覺(jué)穩(wěn)態(tài)誘發(fā)電位(ASSR)各項(xiàng)參數(shù)進(jìn)行對(duì)比研究,探討蝸后病變ASSR存在的一些特異性現(xiàn)象,幫助臨床更準(zhǔn)確地診斷蝸后聽(tīng)力損害。方法:選取2008-2012年間我院兒童聽(tīng)力中心診斷為"蝸后聽(tīng)覺(jué)神經(jīng)損害"并同時(shí)進(jìn)行了ASSR測(cè)試的95例(179耳)患兒作為蝸后病變組;選取同時(shí)期診斷為重度及以上"蝸性聽(tīng)覺(jué)神經(jīng)損害"并同時(shí)進(jìn)行了ASSR測(cè)試、且與蝸后病變組相同年齡范圍的81例(143耳)患兒作為蝸性病變組;選取本兒童聽(tīng)力中心數(shù)據(jù)庫(kù)中正常聽(tīng)力并有ASSR測(cè)試記錄、且與蝸后病變組相同年齡范圍者共26例(50耳)作為正常對(duì)照組。分別比較上述3組測(cè)試對(duì)象間ASSR閾值、引出率及ASSR聽(tīng)力圖類(lèi)型的異同。結(jié)果:1ASSR閾值:蝸后病變有波Ⅴ有波Ⅰ分化小組各頻點(diǎn)的閾值與蝸性病變小組比較,其500、1 000Hz閾值間差異無(wú)統(tǒng)計(jì)學(xué)意義,2 000、4 000 Hz閾值間有統(tǒng)計(jì)學(xué)差異;蝸后病變無(wú)波Ⅴ無(wú)波Ⅰ分化小組各頻點(diǎn)的閾值均較蝸性病變對(duì)應(yīng)小組500、1 000、2 000、4 000 Hz 4個(gè)頻點(diǎn)的閾值均有下降。2ASSR引出率:蝸性病變組無(wú)波Ⅴ分化者500、1 000、2 000、4 000 Hz各頻點(diǎn)的閾值引出率顯著性較蝸后病變各小組相對(duì)應(yīng)頻率點(diǎn)的引出率為低。3引出ASSR反應(yīng)頻點(diǎn)數(shù)量:蝸后病變組能引出全部4個(gè)頻點(diǎn)ASSR反應(yīng)的比例顯著高于蝸性病變組。4ASSR聽(tīng)力圖類(lèi)型:蝸后病變組的ASSR聽(tīng)力圖上升型曲線的比例分別為26.83%(有波Ⅰ波Ⅴ分化)、40%(有波Ⅰ無(wú)波Ⅴ分化)和33.80%(無(wú)波Ⅰ波Ⅴ分化),遠(yuǎn)高于蝸性病變組。結(jié)論:1臨床上ABR重度以上異常的小兒,當(dāng)ASSR測(cè)試出現(xiàn)上升型聽(tīng)力圖時(shí),應(yīng)考慮可能存在蝸后病變的可能;2ASSR反應(yīng)閾不能用于判斷蝸后病變患兒的聽(tīng)力損失嚴(yán)重程度。
[Abstract]:Objective: to compare the (ASSR) parameters of cochlear lesion and retrocochlear lesion in children with severe sensorineural hearing disorder and retrocochlear lesion, and to explore some specific phenomena of ASSR in retrocochlear lesion. To help clinical diagnosis of retrocochlear hearing loss more accurately. Methods: from 2008 to 2012, 95 children (179 ears) who were diagnosed as "retrocochlear auditory nerve damage" by hearing center in our hospital were selected as retrocochlear lesion group. At the same time, 81 cases (143 ears) with severe cochlear auditory nerve damage diagnosed at the same time and with the same age range as retrocochlear lesion group were selected as cochlear lesion group. A total of 26 children (50 ears) with the same age range as the retrocochlear lesion group were selected as the normal control group. The ASSR threshold, the extraction rate and the type of ASSR audiogram were compared among the above three groups. Results 1 ASSR threshold: there was no significant difference in the threshold value of 500-1 000Hz between retrocochlear lesion group and cochlear lesion group (P < 0.05). There was no significant difference between the threshold of 500-1 ASSR and that of cochlear lesion group (P > 0.05). There was no significant difference between the threshold of 500-1 ASSR and that of cochlear lesion group. The threshold value of each frequency of no wave V wave 鈪，

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