新生儿重度高胆红素血症与听力损伤的相关性研究

发布时间：2018-05-08 02:28

本文选题：新生儿重度高胆红素血症 + 听力损伤　；参考：《上海交通大学学报(医学版)》2017年10期

【摘要】：目的·探讨重度高胆红素血症患儿听力损伤相关高危因素和随访预后。方法·对2015年6月至2016年6月上海儿童医学中心新生儿科收治的106例重度高胆红素血症患儿,按照胆红素水平分为3组:重度高胆红素血症组[血清总胆红素(TSB)峰值大于342.0μmol/L且小于427.5μmol/L]、极重度高胆红素血症组(TSB峰值范围427.5~513.0μmol/L)、危险性高胆红素血症组(TSB峰值大于513.0μmol/L)。在出院前用自动脑干听觉诱发电位(AABR)进行听力筛查,对筛查未通过的患儿于3月龄时进行诊断性脑干听觉诱发电位(ABR)检查,并对所有患儿(3月龄和6月龄)随访听性行为反应观察状况。结果·3组患儿共106例,出院前AABR筛查未通过33例(33/106,31.13%),其中重度高胆红素血症组未通过22例(22/86,25.58%),极重度高胆红素血症组未通过9例(9/16,56.25%),危险性高胆红素血症组未通过2例(2/4,50.00%),各组之间差异有统计学意义(均P0.05)。通过专人负责定期宣教,出院前AABR筛查未通过的33例患儿全都于3月龄时来院接受诊断性ABR检查,结果 2例患儿被诊断为轻度听力损伤,但其中1例考虑为中耳炎所致。同时,全部106例重度高胆红素血症患儿完成3月龄和6月龄听性行为反应观察,结果状况良好。结论·重度高胆红素血症是新生儿听力损伤的高危因素之一,TSB水平越高,听力损伤也越明显。重度高胆红素血症引起的听力损伤可能可逆,但也提示听力随访计划有待完善。重度高胆红素血症造成的听力损伤可能对患儿日常生活无明显影响,仍需对患儿进行长期随访。
[Abstract]:Objective to investigate the risk factors and prognosis of hearing loss in children with severe hyperbilirubinemia. Methods from June 2015 to June 2016, 106 children with severe hyperbilirubinemia were treated by Shanghai Children's Medical Center. According to the level of bilirubin, it was divided into three groups: severe hyperbilirubinemia group [serum total bilirubin peak value > 342.0 渭 mol/L and less than 427.5 渭 mol/L], extremely severe hyperbilirubinemia group with TSB peak value of 427.5V 513.0 渭 mol / L, and risk hyperbilirubinemia group with TSB peak value greater than 513.0 渭 mol / L. Automatic brainstem auditory evoked potential (AABR) was used for hearing screening before discharge, and diagnostic brainstem auditory evoked potential (ABR) was examined in children who failed the screening at the age of 3 months. All the children were followed up for 3 months and 6 months of age. Results there were 106 cases in 3 groups. Before discharge, 33 cases of AABR did not pass 33 / 10 / 10 6 / 31.13, including 22 cases of severe hyperbilirubinemia group, 9 cases of very severe hyperbilirubinemia group and 9 cases of very severe hyperbilirubinemia group, and 2 cases of dangerous hyperbilirubinemia group did not pass 2 / 4 50.005%, the difference was statistically significant (P 0.05). 33 children who failed AABR screening before discharge were all admitted to hospital for diagnostic ABR examination at 3 months of age. The results showed that 2 cases were diagnosed as mild hearing impairment, but 1 case was considered to be caused by otitis media. At the same time, all 106 children with severe hyperbilirubinemia completed 3 and 6 months of auditory behavioral response observation, the results were good. Conclusion severe hyperbilirubinemia is one of the high risk factors of neonatal hearing loss. The hearing loss caused by severe hyperbilirubinemia may be reversible, but it also suggests that the hearing follow-up plan needs to be improved. The hearing loss caused by severe hyperbilirubinemia may not affect the daily life of the children.
【作者单位】：上海交通大学医学院附属上海儿童医学中心新生儿科;
【分类号】：R722.1

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