245例新生儿重症监护室早产儿听力筛查结果分析_早产儿重症监护室
[摘要] 目的 总结分析新生儿重症监护室（NICU）早产儿听力筛查情况，旨在早发现、早诊断听力障碍患儿，及时进行干预治疗。 方法 采用听觉脑干反应ABR听力筛查仪对245例早产儿听力进行初筛，未通过的在出生后42 d左右进行复筛，复筛未通过的则转诊至上级医院确诊和治疗。所有有并发症的早产儿在纠正胎龄3月龄左右均再行ABR复筛。 结果 初筛不通过78例，阳性率为31.8%，其中＜34周早产儿56例。复筛不通过11例，阳性率14.1%，均到上级医院进行确诊，5例确诊为听力障碍，异常率为2.04%，其中3例合并有高胆红素血症，2例合并有重度窒息。再次复筛有1例合并高胆红素血症的早产儿未通过，转上级医院确诊为听力障碍。 结论 早产儿听力障碍发生率高，ABR与胎龄、并发症有关系。早产儿出生后3～6个月再次复查ABR很有必要。
[关键词] 新生儿重症监护室；早产儿；听觉脑干反应；听力筛查
[中图分类号] R715.8 [文献标识码] A [文章编号] 1674-4721（2012）07（c）-0055-02
Hearing screening analysis of 245 prematurity hospitalized children in a neonate intensive care unit
LONG Yinyun
Maternity and Children"s Health Care Center of Changde City in Hunan Province, Changde 415700, China
[Abstract] Objective To analyze hearing screening data for prematurity hospitalized children in a NICU and to intervene the infants with possible hearing problems. Methods Initial screening via Auditory Brainstem Response was conducted among 245 premature infants and the infants who didn’t pass the test took the second screening. The infants who failed the second test were transferred to the higher-level hospital for diagnosis and treatment. All the patients with complications took the ABR screening again after gestational age was about three months. Results Seventy eight patients showed 32.8% positive results in the initial screening, 56 of whose gestation age were under 34 weeks. Eleven patients showed 14.1% positive results in the second screening and 5 of them were diagnosed with dydausia in the higher-level hospital. The abnormal rate was 2.04%, 3 of the patients were associated with hyperbilirubinemia and 2 with severe asphyxia. One patient with hyperbilirubinemia failed the third screening and was diagnosed with dydausia. Conclusion Incidence of premature infants have a greater incidence of dydausia. The results of ABR is related to gestational age and complications. It is necessary for premature infants to take ABR review 3-6 months after birth.
[Key words] Neonate intensive care unit; Premature infant; Auditory brainstem response; Hearing screening
听力障碍是新生儿缺陷之一，高危新生儿听力障碍的发病率明显高于正常新生儿[1]。本院新生儿重症监护室（NICU）收住的高危儿中以早产儿占多数，早产早已作为听力损失高危因素之一被美国婴幼儿联合委员会列入2000年形式声明中，因此早发现、早诊断、早干预的“三早”共识[2-3]显得尤为重要。现对本院新生儿重症监护病房中的早产儿听力筛查模式及结果进行分析，报道如下：
1 资料与方法
1.1 一般资料
搜集本院2009年3月～2010年3月入住新生儿重症监护病房的早产儿245例，其中，男134例，女111例。胎龄30～36周，平均34.5周；出生体重1 000～2 512 g，平均2 105g；合并颅内出血26例，窒息47例，高胆红素血症67例，呼吸窘迫综合征35例，双胎19例，先心病3例；无先天性神经系统及耳疾患，未使用耳毒性药物，无特殊家族史。