脑性瘫痪伴听力障碍患儿34例临床分析

目的:探究脑性瘫痪伴听力障碍患儿的临床特点及早期干预措施.方法:选择2011年5月至2014年1月诊断为脑性瘫痪的患儿,对其进行听力诊断,记录所有患者的听觉脑干诱发电位诊断.对诊断患有听力障碍的患儿给予早期干预措施,记录康复训练2个月后的听觉脑干诱发电位诊断结果.结果:100例脑瘫患儿中判定为听力障碍者34例,其中轻度听力损伤2例(5.9％),分别为感觉神经性耳聋1例,蜗后聋1例,双耳2例;中度听力损伤5例(14.7％),分别为感觉神经性耳聋4例,蜗后聋1例,双耳4例,单耳1例;重度听力损伤3例(8.8％),均为感觉神经性耳聋,双耳3例;极重度听力损伤24例(70.6％),分别为感觉神经性耳聋16例,蜗后聋8例,双耳21例,单耳3例.经过2个月的康复训练,34例患儿重度和极重度听力障碍比例明显下降,干预前后患儿听力损伤程度差异有统计学意义(P<0.01).结论:诊断为脑性瘫痪患儿可能具有严重的听力障碍,以感觉神经性耳聋和蜗后聋为主,极重度的听力障碍患儿占据较大比例.经过早期康复训练干预,能够显著改善脑性瘫痪患儿的听力障碍,值得在临床上推广.

Clinical analysis of the cerebral palsy complicated with hearing impairment in children

Objective:To investigate the clinical features of the cerebral palsy complicated with hearing impairment and its early intervention measures in children. Methods:The hearing and auditory brainstem response(ABR) in children diagnosed by cerebral palsy were examined from May 2011 to January 2014. The hearing impairment children were treated with early intervention,and the ABR of children were recorded after two months of rehabilitation. Results:Thirty-four children with deaf in 100 children were diagnosed. The mild hearing impairment in 2 cases(5. 9％) were found,which included 1 case of sensorineural deafness,1 case of retrocochlear deafness and 2 cases of both ears. The moderate hearing impairment in 5 cases(14. 7％) were found,which included 4 case of sensorineural deafness, 1 case of retrocochlear deafness, 4 cases of both ears and 1 case of one ear. The severe hearing impairment in 3 cases(8. 8％) were found,which was sensorineural deafness and in both ears. The extreme severe hearing impairment in 24 cases(70. 6％) were found,which included 16 case of sensorineural deafness,8 case of retrocochlear deafness,21 cases of both ears and 3 cases of one ear. The proportion of the severe and extreme severe hearing impairment children in 34 cases with cerebral palsy complicated with hearing impairment significnatly decreased after 2 months of rehabilitation. The difference of the degree of hearing impairment in children between before and after intrvention was statistically significant(P<0. 01). Conclusions:Among the children with cerebral palsy complicated with hearing impairment,the sensorineural and retrocochlear deafness is the majority,and the proportion of the extreme severe hearing impairment children is high. The early rehabilitation intervention training can significantly improve the hearing impairment in children with cerebral palsy,which is worthy of use in clinic.