新生儿高胆红素血症听力筛查临床分析

目的:探讨新生儿重症监护病房(NICU)中新生儿高胆红素血症听力筛查方法和听力障碍发病情况,为早期治疗听力障碍提供理论依据。方法:随机筛查135例高胆红素血症新生儿,按其血清胆红素水平分为轻、中、重3度,采用畸变产物耳声发射(DPOAE)对其进行初筛,未通过者4周后作第2次复查,仍未通过者于3月龄进行听觉脑干诱发电位(ABR)检查。结果:高胆红素血症的患儿DPOAE初筛及复筛的异常率的改变与血清胆红素浓度密切相关,轻度组DPOAE异常率较低,中、重度组则依次增高,血清胆红素水平越高,DPOAE异常率越高,异常越严重。初筛3个月后对轻、中、重度异常者进行了ABR检测,轻度组恢复较好,重度组恢复较差,异常率高,差别具有显著性。结论:NICU中高胆红素血症是造成听力障碍的高危因素,听力障碍的发生与血清胆红素浓度相关,新生儿高胆红素血症应常规进行听力筛查,DPOAE结合ABR是一种较好的高危新生儿听力筛查方法。

Clinical analysis of hearing screening of neonates with hyperbilirubinemia

Objective:To evaluate the hearing screening methods and incidence of hearing obstacle of neonates with hyperbilirubinemia in neonatal intensive care unit for supplying theoretical base of early treatment.Methods:135 neonates of term infants with hyperbilirubinemia were divided three groups,such as light,middle and heavy degree. DPOAE were enrolled firstly and the abnormal one was rechecked after four weeks. ABR were enrolled to abnormal ones also in second detection followed up for three months.Results:In 135 neonates with hyperbilirubinemia, abnormal rates of DPOAE detection were associated with the level of serum bilirubin concentrations. Abnormal rates of light degree group was low than that in other two groups,and the more higher level of serum bilirubin concentrations, the more higher abnormal rates was. At three months follow up of ABR detection,the results showed that the resumption rate of light degree group were better than that in heavy degree group.Conclusion:Neonates with hyperbilirubinemia incidence in neonatal intensive care unit are high risk factor for hearing obstacle. The accidence of hearing obstacle is associated with the level of serum bilirubin concentrations. Combination of ABR and DPOAE in hearing screening of neonates with hyperbilirubinemia is more accurate and sensitive.