高胆红素血症患儿治疗后听力随访结果分析

发布时间：2018-07-14 12:28

【摘要】：目的分析高胆红素血症患儿治疗后的听力随访结果。方法 573例高胆红素血症患儿(观察组)按黄疸干预方法分为换血组(67例,血清胆红素浓度344.2~1 107.2μmol/L,平均457.9μmol/L)和光疗组(506例,血清胆红素浓度205.2~572.6μmol/L,平均285.2μmol/L),分别进行听力初筛、复筛,复筛未通过者于3月龄内进行听力学诊断,听力异常者采用听性脑干反应、畸变产物耳声发射和声导抗等进行听力检测,听力随访至24月龄,比较两组听力损失情况,并与836例正常新生儿(对照组)比较。结果 3月龄听力学诊断时观察组听力损失发生率为5.76%(33/573),对照组为0.72%(6/836);随访至24月龄时,观察组听力损失发生率(3.49%,20/573)高于对照组(0.24%,2/836),差异有统计学意义(P0.05),换血组听力损失发生率(25.37%,17/67)高于光疗组(0.59%,3/506),差异有统计学意义(P0.05),观察组中听力损失者主要表现为双侧极重度聋(80%,16/20)和蜗后病变(65%,13/20)。结论高胆红素血症患儿需换血治疗者更易发生听力损失,且以双侧极重度聋和蜗后病变为主,多为不可逆性改变。
[Abstract]:Objective to analyze the hearing follow-up of children with hyperbilirubinemia after treatment. Methods 573 children with hyperbilirubinemia (observation group) were divided into two groups according to the intervention of jaundice: hemodialysis group (67 cases, serum bilirubin concentration 344.2U / L 1 107.2 渭 mol / L, mean 457.9 渭 mol / L) and phototherapy group (506 cases, serum bilirubin concentration 205.2 渭 mol / L, mean 285.2 渭 mol / L). The patients with abnormal hearing were diagnosed by audiology within 3 months of age. Auditory brainstem reaction, distortion product otoacoustic emission and acoustic conductance were used to detect hearing. The hearing was followed up to 24 months of age, and the hearing loss was compared between the two groups. And compared with 836 normal neonates (control group). Results the incidence of hearing loss was 5.76% (33 / 573) in the observation group and 0.72% (6 / 836) in the control group at the age of 3 months. The incidence of hearing loss in the observation group (3.4920 / 573) was significantly higher than that in the control group (0.2420 / 836), the difference was statistically significant (P0.05). The incidence of hearing loss in the hemodialysis group (25.37g / 67) was higher than that in the phototherapy group (0.59g / 3 / 506), the difference was statistically significant (P0.05). Deafness (80 / 20) and retrocochlear lesions (6513 / 20). Conclusion Children with hyperbilirubinemia are more likely to suffer from hearing loss in patients with hyperbilirubinemia in need of hemodialysis, and bilateral extremely severe deafness and retrocochlear lesions are the main causes, most of which are irreversible changes.
【作者单位】：广西柳州市妇幼保健院;首都医科大学附属北京同仁医院;
【基金】：卫生行业科研专项项目(201202005) 广西柳州市应用技术研究与开发计划课题2010030732
【分类号】：R764

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