【摘要】：目的:分析嬰幼兒未通過聽力篩查的原因及嬰幼兒聽神經(jīng)病的臨床聽力學(xué)特征 方法:檢測(cè)對(duì)象來自2009年5月—2010年2月廣州及周邊地區(qū)2次篩查未能通過或前后2次篩查結(jié)果不一致而轉(zhuǎn)診到我科進(jìn)行聽力學(xué)評(píng)估,少部分出生已通過當(dāng)?shù)貗D幼保健院所作的聽力篩查,但至4、5月齡,家長(zhǎng)發(fā)現(xiàn)患兒對(duì)聲音反應(yīng)差,而到我院做聽力學(xué)檢測(cè)評(píng)估的6個(gè)月齡內(nèi)的嬰幼兒,共952例1882耳㖞,做聽性腦干反應(yīng)auditory brainstem response, ABR㖞、畸變產(chǎn)物耳聲發(fā)射distortion product otoacoustic emissions, DPOAE㖞、鼓室聲導(dǎo)抗和鐙骨肌反射測(cè)試。 結(jié)果:無高危組聽力篩查通過率高于高危因素組P0.05或P0.01㖞;無高危組聽力損失低于高危因素組P0.05㖞;早產(chǎn),極低體重,新生兒窒息,宮內(nèi)病毒感染,機(jī)械通氣≥5天,≥2個(gè)高危因素的ABR反應(yīng)閾值與無高危因素組之間的差異有顯著性P0.05或P0.01㖞;多因素logistic回歸分析發(fā)現(xiàn)早產(chǎn),極低體重,耳聾家族史,頜面畸形,機(jī)械通氣≥5天可作為聽力損失的高危因素。其中11例嬰幼兒因耳蝸和聽神經(jīng)反應(yīng)分離DPOAE通過,ABR無反應(yīng)㖞而診斷為聽神經(jīng)病 結(jié)論:新生兒聽力篩查是一項(xiàng)長(zhǎng)期艱巨的任務(wù),對(duì)有高危因素的患兒應(yīng)加強(qiáng)篩查力度,積極預(yù)防和治療新生兒圍產(chǎn)期高危影響因素,減少聽力損失的發(fā)病率;耳聲發(fā)射正常和聽性腦干反應(yīng)及其反應(yīng)閾之間的嚴(yán)重不一致性,鼓室圖正常,鐙骨肌反射引不出是嬰幼兒聽神經(jīng)病較為顯著的臨床聽力學(xué)特征,可用于嬰幼兒聽神經(jīng)病的早期診斷。
[Abstract]:Objective: to analyze the causes of hearing failure in infants and young children and the clinical audiological characteristics of auditory neuropathy in infants. Methods: the subjects from May 2009 to February 2010 in Guangzhou and the surrounding areas failed to pass the screening. Or two times after the screening results were inconsistent and referred to my department for audiology evaluation, A small number of births have passed the hearing screening conducted by the local maternal and child health care center, but by the age of 45 to 5 months, parents found that the children had a poor response to sound, while to the children within 6 months of age who were assessed by audiology in our hospital, a total of 952 cases? 1882 ears? Auditory brainstem response? auditory brainstem response, ABR?, distortion product otoacoustic emission? distortion product otoacoustic emissions, DPOAE?, tympanic acoustic impedance and stapes reflex. Results: the passing rate of hearing screening in non-high risk group was higher than that in high risk factor group (P0.05 or P0.01), and the hearing loss in non-high risk group was lower than that in high risk factor group (P0.05). The ABR response threshold of premature delivery, very low body weight, neonatal asphyxia, intrauterine virus infection, mechanical ventilation 鈮，

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