前庭导水管扩大患儿的发现途径与首诊年龄

发布时间：2018-07-29 09:11

【摘要】：目的:探讨前庭导水管扩大患儿的发现途径与首诊年龄,以及二者与听力损失程度之间的关系。方法:2009-01-2014-04期间,在我院儿童听力诊断中心就诊、确诊为前庭导水管扩大的122例患儿,按发现途径分为筛查组与未筛查组:筛查组分为双耳未通过组、单耳未通过组及双耳通过组;未筛查组分为声音不敏感组、言语发育不良组、突发性听力下降及其他组。分析各组发现途径与首诊年龄之间的关系,并分别对各组的发现途径及首诊年龄与听力损失程度的关系进行统计学分析。结果:筛查组84例(68.85%),平均首诊年龄(17.24±17.08)个月;未筛查组37例(31.15%),平均首诊年龄(30.92±18.21)个月,筛查组较未筛查组的首诊年龄提早,差异有统计学意义(P0.01)。筛查组中,双耳通过占14.29%(12/84),双耳或单耳未通过占85.71%(72/84),其中双耳未通过占67.85%(57/84),单耳未通过占17.86%(15/84),3组平均首诊年龄差异有统计学意义(χ2=15.616,P0.01),两两比较显示双耳通过组较双耳未通过组的首诊年龄晚(P0.01);未筛查组中,对声音不敏感组的首诊年龄[(19.69±11.16)个月]较言语发育不良组[(37.13±15.62)个月]和突发性听力下降组[(47.40±24.70)个月]提早,差异有统计学意义(P0.01)。筛查组和未筛查组听力损失程度比较差异无统计学意义(P0.05),而未筛查组中轻中度听力损失比极重度听力损失的首诊年龄晚(P0.01)。结论:研究提示,绝大部分前庭导水管扩大患儿可以通过新生儿听力筛查得到早期发现和早期诊断,但部分患儿表现为迟发性或渐进性听力损失,尤其是轻中度听力损失发现较晚,值得临床关注。
[Abstract]:Objective: to investigate the relationship between the discovery of vestibular aqueduct enlargement and the age of first diagnosis and the degree of hearing loss in children with enlarged vestibular aqueduct. Methods between 2009-01-2014-04, 122 children diagnosed as vestibular aqueduct dilatation in our hospital were divided into screening group and non-screening group according to the way of discovery: the screening group was divided into two groups: the binaural group, the monaural group and the binaural group. The unscreened group was divided into sound insensitive group, speech dysplasia group, sudden hearing loss group and other groups. The relationship between the discovery pathway and the age of first diagnosis was analyzed, and the relationship between the discovery pathway, the age of first diagnosis and the degree of hearing loss was analyzed statistically. Results: there were 84 cases (68.85%) in the screening group with an average age of (17.24 卤17.08) months for the first visit, and 37 cases (31.15%) in the non-screening group, with an average age of (30.92 卤18.21) months. The first diagnosis age of the screening group was earlier than that of the non-screening group (P0.01). In the screening group, The average age of first diagnosis in the binaural passage group was 14.29% (12 / 84), the binaural or monaural failure rate was 85.71% (72 / 84), the binaural failure rate was 67.85% (57 / 84), and the monaural failure rate was 17.86% (15 / 84). Late age (P0.01); non-screening group, The age of first diagnosis in the insensitive group [(19.69 卤11.16) months] was significantly earlier than that in the speech dysplasia group [(37.13 卤15.62) months] and the sudden hearing loss group [(47.40 卤24.70) months] (P0.01). There was no significant difference in the degree of hearing loss between the screening group and the non-screening group (P0.05), while the first diagnosis age of the mild to moderate hearing loss in the non-screening group was later than that of the extremely severe hearing loss group (P0.01). Conclusion: most of the children with enlarged vestibular aqueduct can get early detection and diagnosis through neonatal hearing screening, but some of them have delayed or progressive hearing loss. In particular, mild to moderate hearing loss is found late and deserves clinical attention.
【作者单位】：首都医科大学附属北京同仁医院;北京市耳鼻咽喉科研究所;耳鼻咽喉头颈科学教育部重点实验室(首都医科大学);
【基金】：卫生公益性行业科研专项基金(No:201202005) 首都医学发展科研基金项目(No:2009-1049) 首都临床特色应用研究专项基金(No:Z131107002213123)
【分类号】：R764.43

【参考文献】