微量元素铁对婴幼儿听力的影响研究

目的:研究铁元素对婴幼儿听力的影响。方法:采用原子吸收法检测6405名婴幼儿血铁的含量,丹麦产PA5便携式婴幼儿测听仪主观进行目标筛查。结果:血铁异常组听力筛查不通过率为0.68%,血铁正常组听力筛查不通过率为0.10%,两组相比差异有统计意义。结论:婴幼儿血铁降低是听力异常的相关因素之一。     

100例学龄前聋幼儿纯音测听体会

纯音测听是指利用听力计，按一定的规则，对听力损失的性质和程度、频率反应特性进行测验后绘出听力图的一种方法，叫纯音测听（主观测听）。因能较全面反映听力损失情况，所以是验配助听器，设计康复程序的主要依据。因该检测需受试者密切配合，临床能做到的最小聋幼儿为７岁左右［１］，７岁以下者仅通过行为测听和脑干诱发电位进行粗估。目前，北京、长春、武汉、广州等地借鉴国外经验开展视觉强化测听（婴幼儿）、学龄前聋幼儿的配景测听［２］，效果尚未得到统一公认。笔者在聋幼儿听觉语言康复实践测听工作中，接触了大量的学龄前聋幼…     

职业性噪声聋患者听觉脑干诱发电位检测结果的分析

目的 对职业健康检查筛查出的职业性噪声聋患者和30例听力正常者听觉脑干诱发电位(brainstem auditory evoked potentials,BAEP)检测结果进行对比分析.方法 使用纯音测听仪和BAFP仪,分别对43例职业性噪声聋患者和30例正常人员进行检测,比较纯音测听主观听阈值与BAEP反应阈的关系,以及BAEP诸波的潜伏期和波峰间值的变化.结果 职业性噪声聋病例BAEP检测中刺激反应阈与纯音测听值间存在正相关.在80 dB强刺激下,Ⅰ波潜伏期的延长是BAEP明显的变化,且Ⅰ波的延长与刺激反应阈呈正相关.BAEP检测可客观地反映职业性噪声聋听力损伤以高频损伤为重的特点,但是,由于BAEP检测自身的局限性,使BAEP检测反应阈较主观纯音测听阈值高,使得BAEP检测结果与纯音测听检测结果间存在差异,本组病例中两者均值相差(14.56±7.65)dB,单一的高频纯音测听不能完全准确反映听力损伤的程度,成为BAEP检测用于职业性噪声聋诊断中需解决的问题.结论 BAEP检测反应阈与纯音测听值的正相关性和Ⅰ波潜伏期的明显改变,使得BAEP检测可成为职业病临床辨别伪聋,确定耳聋性质极为有利的客观手段.     

107例婴儿听力检测临床观察

婴幼儿期是对听力障碍作出诊断并实施有效方法进行治疗和语言训练的关键时期,此期是人一生中语言和脑发育最为迅速的阶段,早期发现小儿听力障碍,尽早地确诊耳聋的性质和程度,积极有效地利用残余听力,加强听觉语言训练,争取聋而不哑。为了解嘉兴市婴儿听力情况,早期发现异常,早期干预,1998年本院运用婴幼儿医学测听仪(简称PA),进行了临床调查,以下是对107例214只人耳检测的结果以及相关因素的分析。     

安普莱德—455测听仪在职业噪声体检中的功能介绍

安普莱德-455测听仪是意大利1992年生产的听力诊断仪，能提供8种实验的预选程序编制，以完成耳蜗后及蜗后机能障碍、中枢性功能障碍和无器质性听力损失的基本评价。[1]它配有监听、助听和物声系统及噪声掩蔽和打印装置，符合GB7341—87[2]推荐的Ⅰ型听力计性能要求，且声级和频率稳定，分别为士1．5％和0．5％，均小于标准中的士3％。安普莱德可直观屏幕显示听力图．修改曲线，方便操作者观察信号变化，现将本仪器在职业噪声体检中的功能介绍如下。1．气导与骨导的一般测听功能测试受检耳在有或无掩蔽下的听力丧失程度。2．纯音阈上测听功…     

小儿行为测听在人工耳蜗植入术后调试中的临床效果观察

目的探讨小儿行为测听在人工耳蜗植入术后调试中的临床效果,旨在为临床提供参考。方法选择2011年1月-2015年11月在宁波大学医学院附属医院接受人工耳蜗植入的患儿36例作为研究对象,所有患儿均能配合完成声场测听。根据行为测听结果调整对应电极的T值,对平均听阈35dB HL的患儿调整T值后再次测听。结果 36例患儿均成功植入人工耳蜗,手术过程顺利。20例患儿进行儿童视觉强化定向条件反应测试(VRA),16例患儿进行儿童游戏测听(PA)。结果显示极重度感音神经性聋14例,重度感音神经性聋17例,中重度感音神经性聋5例,VRA和PA听力检查比较差异无统计学意义(P0. 05)。36例受试患儿中22例编程调试后行行为测听,平均听阈≤35dB HL,此22例儿童认为T值设置比较合适,未进行再次调试; 11例患儿根据第1次行为测听的结果改变T值后平均阈值下降≤5dB HL; 2例患儿在调整T值后阈值反而提高,最后采用第1次调试的T值; 1名患儿调整T值后阈值无改变。36例患儿家属中总满意率为94. 44%。结论小儿行为测听在人工耳蜗植入术后调试中的临床效果显著,值得临床借鉴。     

191例婴幼儿多频稳态听觉诱发反应测听的临床分析

目的:探讨利用多频稳态听觉诱发反应(ASSR)听阈预测的纯音听力图对婴幼儿进行分频率听力评估的可行性。方法:采用美国GSI-Audera多频稳态听觉诱发电位(ASSR)对正常婴儿15例(30耳)、70例(121耳)2次以上耳声发射(OAE)复筛仍阳性的婴幼儿以及106例(212耳)疑有听力障碍的婴幼儿进行了测试。结果:听力正常组预测纯音的听力评估平均为(19·56±3·8)dBHL;70例(121耳)2次以上(OAE)复筛阳性的婴幼儿ASSR听力评估结果为正常:8耳;轻度:55耳;中度:39耳;中重度:8耳;重度:6耳;极重度:5耳。106例(212耳)疑有听力障碍婴幼儿ASSR听力评估结果正常:74耳,轻度:26耳,中度:26耳,中重度:2耳,重度:5耳,极重度:79耳。结论:利用ASSR听阈预测的纯音听阈来进行分频率听力评估,是1种具有频率特性、可靠的客观测听方法。很适于婴幼儿客观测听以及新生儿听力筛查阳性后续进行详细的分频率听力评估的有效检测方法。     

电测听仪使用操作体会

随着对噪声性耳聋的深入研究,电测听仪已成为一种必不可少的仪器。在基层经常需要开展大批量的体检工作,加之电测听仪操作比较麻烦,特别是纯音衰减器一个频率就要上下调节好几次。检查一侧听力至少有九个频率,如检查一个人需要15～20分钟,遇列疑难病人需要的时间就更长了。为了既准确又快地操作电测听仪,我在工作中逐渐体会到一、操怍人员首先必须正确掌握仪器的使用操作     

江门市幼儿园4～6岁儿童听力筛查

为了解我市幼儿听力现状,早期发现听力功能损害,及早提出干预措施,使聋哑儿最大程度发展残余听力,达到聋而不哑,我院于1996年8～9月对28间幼儿园6077名4～6岁儿童进行听力筛查。 1.方法 选择安静的房间、墙壁无镜子,使用协和招商听力康复部研制的行为测听仪,测查前调查者向小儿说明测查方法,并     

性别、耳别因素对听筛未过婴幼儿听力诊断结果的影响

目的:探讨性别、耳别因素对听力筛查未过婴幼儿听力诊断结果的影响。方法:回顾性分析5 710名听筛未过婴幼儿的资料。并分别对不同性别、不同耳别的听力诊断结果进行统计学分析。结果:5 710例听筛未过婴幼儿中男性有3 496例,女性有2 214例。男婴听力损失发生率为48.85%。女婴听力损失发生率为48.83%,两组听力损失发生率的差异无统计学意义(P>0.05)。5 710例(11 420耳)听筛未过婴幼儿中,左耳听力损失发病率为68.00%,右耳听力损失发生率为60.25%,说明左右耳听力损失发生率的差异无统计学意义(P>0.05)。结论:听筛未过婴幼儿的听力损失发生率不存在明显的性别和耳别差异,但左耳听力损失发生的耳数略多于右耳。此次研究样本量有限,听力损失发生率是否存在耳别上的差异还需进一步研究。     

Contraceptive efficacy and clinical performance of Nestorone implants in postpartum women

The objective of this study was to evaluate the contraceptive efficacy and clinical performance of a Nestorone subdermal implant (NES) in the postpartum period. NES (n = 100) and Copper T intrauterine device (T-Cu; N = 100) acceptors initiated contraception at 8 weeks postpartum and were followed at monthly intervals during the first year and at 3-month intervals thereafter. Pregnancy rates, breastfeeding performance, infant growth, bleeding pattern, and side effects were assessed. Blood and milk NES concentration were measured.

No pregnancy occurred in 2195 and 2145 woman-months of NES implant and T-Cu use, respectively. No effect of NES on lactation and infant growth and no serious adverse events were observed. Lactational amenorrhea was significantly longer in NES users (353 ± 20 days) than in T-Cu users (201 ± 11 days). More NES users (55.8%) experienced prolonged bleedings than did T-Cu users (36.2%). Concentrations of NES in breast milk ranged between 54–135 pmol/liter. The Nestorone implant is a highly effective contraceptive, safe for breastfed infants because the steroid is inactive by the oral route.     

Effects of the etonogestrel-releasing implant Implanon and a nonmedicated intrauterine device on the growth of breast-fed infants

The study objectives were to compare the effects of an etonogestrel-releasing implant (Implanon) and a nonmedicated intrauterine device (IUD) on parameters of lactation in breast-feeding women and on the growth of their breast-fed infants over a 3-year period. Healthy lactating women (28-56 days postpartum) chose either the implant (n=42) or the IUD (n=38). Infant growth during a 3-year follow-up period is reported here. Total duration of breast-feeding coinciding with the mothers' treatment was 421.0 and 423.4 days in the Implanon and IUD groups, respectively. There were no differences between the infant groups in terms of body length, biparietal head circumference and body weight. No abnormalities were reported in psychomotor development or during physical examination. No treatment-related side effects were observed in either group. In conclusion, there were no differences in the growth of breast-fed infants of women treated with Implanon or a nonmedicated IUD. Implanon, therefore, appears to be a safe contraceptive option for breast-feeding women and their infants.     

Implantable contraceptives for women: effectiveness, discontinuation rates, return of fertility, and outcome of pregnancies

Progestogen-only contraceptive implants are highly effective. In most studies, 5-year cumulative pregnancy rates are less than 1.5/100 women for Norplant and Norplant II. No study has yet reported any failures with Implanon. Weight over 70 kg and age at insertion under 25 years both increase the failure rate of Norplant and Norplant II; however, data are as yet lacking for Implanon. The effectiveness of other progestogen-only implants for which there are as yet few data are unlikely to be any different. Continuation rates are high compared with other hormonal methods and with the intrauterine device. In most cohorts at least 35% of women, and often many more, are still using Norplant by the end of 5 years. Rates vary according to a number of factors, including population studied, age, and parity. Menstrual disturbance is by far the most common reason for discontinuation, with headache, acne, weight gain, and desire for pregnancy accounting for other common reasons for implant removal. Fertility returns rapidly following implant removal, and pregnancy rates (76-100% 1 year after removal) are usually no different from those following discontinuation of any other contraceptive method. There is no increase in the risk of ectopic pregnancy, fetal malformation, or impaired infant health in pregnancies conceived either during implant use or after removal.     

Acquisition of Speech, Preand Post-Cochlear Implantation: Longitudinal Studies of A Congenitally Deaf Infant

This paper details the process of speech acquisition by the first British, congenitally deaf infant (without additional handicaps) to be fitted with a multi-channel cochlear implant. The infant's phonological and phonetic level development using, firstly, acoustic hearing aids, and secondly a cochlear implant, is thoroughly detailed by use of video and audio-recorded data, taken at weekly intervals and across a variety of contexts. The paper examines the benefit of early implantation for spoken language development and notes the utility of Ling's model of speech acquisition for the habilitation of young, congenitally deaf implant recipients.     

一种婴幼儿体温监测装置的研制

目的：研制一种可以连续监测婴幼儿体温并具备高温报警功能的装置。方法：装置基于MSP430F435单片机研制，采用单片机自带的比较器，计数器与少量外围电路完成高精度体温的测量，同时数据存储于单片机自带的Flash。结果：该装置可实时显示温度监测值及异常报警，同时实现30d不间断测量。结论：该记录系统具有低成本、低功耗、小体积等特点．它为婴幼儿动态体温的医学监测研究提供了经济实用和便于推广的解决方案。     

非消毒包装植入性器械追溯系统的优化方案

分析了上海目前植入性医疗器械追溯管理系统运行中存在的问题。提出了优化方案。该方案在不增加医疗机构人力投八的情况下,可明显提高非消毒包装植入性器械追溯信息的可靠性。     

外置注入式婴儿培养箱消毒装置的实现原理及设计

该研究首先阐述了婴儿培养箱消毒的重要性,然后从臭氧的消毒机理展开讨论,根据婴儿培养箱的结构特点和臭氧消毒的优势,结合临床应用得到臭氧消毒的实现原理,提出一种外置注入式婴儿培养箱消毒装置的设计方法。该设计通过在婴儿培养箱箱体外安装一套消毒装置,利用该装置中的电子臭氧发生器现场制取臭氧消毒气体,经输气管将臭氧消毒气体注入婴儿培养箱箱体内,在一定浓度和时间的作用下达到消毒的目的,为婴儿培养箱消毒提供了一套安全有效、简单实用的臭氧消毒方法,且该消毒装置具有设计合理、创意新颖、制作简单、操作方便,以及消毒无死角、无二次残留污染等优点。     

人工电子耳蜗中语音处理器的研究

语音处理器是人工电子耳蜗系统中重要的一个组成部分。我们设计的语音处理器主要基于TI公司的DSP芯片TMS320VC5409和立体声音频编解码芯片TLV320AIC23B。本文介绍了其整体的设计方案和工作原理,并讨论了人工电子耳蜗系统中专用语音处理集成电路的研究。     

Fertility regulation in nursing women: VII. Influence of NORPLANT levonorgestrel implants upon lactation and infant growth

The objective of this study was to test the influence of NORPLANT implants upon lactation and infant growth. The results obtained during the first postpartum year are reported. One-hundred women were enrolled in the implant group. The control group was formed by 100 women who received a Copper T IUD. Treatments were administered at day 55 +/- 3. At admission all subjects were in exclusive breastfeeding with an adequate weight increase of the infant. No significant differences were found between the treated and control groups in the percentage of women in full nursing at different postpartum intervals, except for the 12th month postpartum where a lower percentage of cases from the NORPLANT group was in the full nursing category. No difference was found in the time of weaning. The infants showed a normal weight gain rate in both groups although the girls from the NORPLANT group showed a significantly lower daily weight increase during the 4th month than the girls from the IUD group. No pregnancies were diagnosed. No women asked for implant removal during the first year. No serious side effects related to treatment were detected. Bleeding irregularities were rare during breastfeeding which is in contrast with what occurs in non-nursing women treated with NORPLANT implants. Levonorgestrel concentrations found in milk were variable and individual values ranged from 23 to 311 pg/ml. The dose received by the infant can be estimated around 15 to 18 ng/Kg/day during the first month of treatment when the higher plasma values of levonorgestrel are observed. These levels is conjunction with the clinical observations reported here minimize the potential problems associated with levonorgestrel transference through maternal milk. Nevertheless, long-term studies are required to settle this matter and until more information is available, NORPLANT implant use in lactating women should be limited to cases who require a highly effective contraceptive method and where non-hormonal methods of similar effectiveness are contraindicated or unacceptable.     

Medical eligibility criteria for new contraceptive methods: combined hormonal patch, combined hormonal vaginal ring and the etonogestrel implant

To review evidence on the combined hormonal patch, combined hormonal vaginal ring and the etonogestrel implant, with a focus on safety and effectiveness of use among women with special health conditions, we searched MEDLINE, Pre-MEDLINE and the Cochrane Library for reports published from 1980 through March 2005. Articles eligible for review included 11 on the hormonal patch, nine on the hormonal ring, and 11 on the etonogestrel implant. Limited evidence suggests patch efficacy is lower among women>90 kg. No evidence was identified for vaginal ring use among women with medical conditions. A single small study found that etonogestrel implants had no adverse effects on bone mineral density among women 18-40 years old. Limited evidence also suggests no adverse effects of the etonogestrel implant on lactation parameters or infant development among users enrolled 28 to 56 days postpartum and followed for 4 months.