98例初筛未通过听力障碍婴幼儿随访情况分析
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摘要
目的探讨初次诊断为听力障碍的婴幼儿随访过程中听力损失的变化及特点。方法对98例初诊为听力障碍的患儿使用耳声发射(OAE)、声导抗、听性脑干反应(ABR)进行定期听力复查,观察患儿的听力变化。结果经随访98例初诊为听力障碍患儿中37例听力恢复正常,61例确诊为听力障碍,其中单耳听力下降13例;双耳48例,听力改善以轻中度为主,占94.7%(54/57)轻中度听力损失患儿ABR阈值与鼓室图好转一致性较高;无高危因素组听力改善好于高危因素组(P<0.01)。结论诊断为听力障碍的婴幼儿应定期进行复诊,轻中度听力损失患儿改善率较高,主要是由于中耳的恢复及中枢的发育及高危病因治疗,但重度/极重度听力损失患儿不易改善,特别是伴有高危因素患儿,应尽早干预。
Objective To study the hearing change and the audiological characteristics of newborns and infants who were diagnosed hearing loss at firse visit. Methods ABR, OAE and acoustic impedance were regularly used to test 98 infants who were diagnosed hearing loss. They were moritored for any hearing change. Results Of the 98 infants in the end of follow up, 37 returned normal, 61 cases were admitted hearing loss, included 13 were unilateral hearing loss,48 were bilateral hearing loss; And mild moderate hearing loss was mainly improved,94.7%(54/57). The improvement of ABR and acoustic impedance for those with mildly moderate hearing loss showed almost perfect agreement, The improvement of high risk factors groups were more noticeable than there with no high risk factors(P<0.01). Conclusion Regular examination should be applied to these infants with hearing loss.The hearing Improvement rate for mildly moderate hearing loss infants is higher because of self recovery from otitis media w ith effusionand outcomes of central auditory system development and treamelent of high risk. Children with severe and profound hearing loss should be early intervened, especially for those infants and young children at high risks.
Objective To study the hearing change and the audiological characteristics of newborns and infants who were diagnosed hearing loss at firse visit. Methods ABR, OAE and acoustic impedance were regularly used to test 98 infants who were diagnosed hearing loss. They were moritored for any hearing change. Results Of the 98 infants in the end of follow up, 37 returned normal, 61 cases were admitted hearing loss, included 13 were unilateral hearing loss,48 were bilateral hearing loss; And mild moderate hearing loss was mainly improved,94.7%(54/57). The improvement of ABR and acoustic impedance for those with mildly moderate hearing loss showed almost perfect agreement, The improvement of high risk factors groups were more noticeable than there with no high risk factors(P<0.01). Conclusion Regular examination should be applied to these infants with hearing loss.The hearing Improvement rate for mildly moderate hearing loss infants is higher because of self recovery from otitis media w ith effusionand outcomes of central auditory system development and treamelent of high risk. Children with severe and profound hearing loss should be early intervened, especially for those infants and young children at high risks.
引文
[1]杨影.新生儿听力筛查、诊断、早期干预的影响因素[J].听力学及言语疾病杂志,2014,22(1):105-108.
[2]刘辉,莫玲燕,吕静,等.226 Hz和1000 Hz鼓室声导纳在不同年龄婴幼儿分泌性中耳炎应用探讨。[J]临床耳鼻咽喉头颈外科杂志,2014,28(10):701-704.
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[8]刘俊秀,马芙蓉,马新春,等.北京市8200例和西宁市1940例新生儿听力筛查结果对比分析[J].听力学及言语疾病杂志,2012,20(5):413-416.
[9]戴桂林,李楚凌,尹宝珠,等.6681例新生儿听力筛查结果分析[J].听力学及言语疾病杂志,2011,19(5):465-466.
[10]王永华,李月,沈丽.114名听力筛查未通过的婴幼儿复诊结果分析[J].中医耳鼻喉科学研究杂志,2014,13(2):32-34.
[11]刘冬丽,侯书杨,余凤娟,等.脑干听觉诱发电位检测在新生儿高胆红素血症中的应用[J].中国实用神经疾病杂志,2016,4(19):109-110.
[12]冀飞,吴南.听神经病的诊断和干预[J].中国听力语言康复科学杂志,2017,15(1):61-66.
[13]吕静荣,黄治物,马衍,等.学龄前儿童迟发性听力损失筛查研究[J].听力学及言语疾病杂志,2013,21(3):221-224.
[14]王靖明,李洁,秦英,等.听力复查不通过的转诊婴儿听力学评估[J].中国耳鼻咽喉颅底外科杂志,2018,24(1):29-32.
[2]刘辉,莫玲燕,吕静,等.226 Hz和1000 Hz鼓室声导纳在不同年龄婴幼儿分泌性中耳炎应用探讨。[J]临床耳鼻咽喉头颈外科杂志,2014,28(10):701-704.
[3]张杰.重视儿童分泌性中耳炎的诊治[J].中国听力语言康复科学杂志,2018,16(1):1-5.
[4]倪道凤.婴幼儿中耳炎的诊断和治疗[J].临床耳鼻咽喉科杂志,2005,19(13):577.
[5]茅学英,陶峥,顾宇,等.不同年龄正常听力新生儿和婴幼儿听性脑干反应波潜伏期分析[J].听力学及言语疾病杂志,2014,22(3):239-241.
[6]彭峤琛,高胜利,罗仁忠,等.高危新生儿的听性脑干反应结果分析[J].中华耳科学杂志,2013,11(1):96-99.
[7]肖志勇,陈文倩,苏雅妃,等.3592例新生儿听力筛查回顾性分析[J].中华耳科学杂志,2018,16(2):253-257.
[8]刘俊秀,马芙蓉,马新春,等.北京市8200例和西宁市1940例新生儿听力筛查结果对比分析[J].听力学及言语疾病杂志,2012,20(5):413-416.
[9]戴桂林,李楚凌,尹宝珠,等.6681例新生儿听力筛查结果分析[J].听力学及言语疾病杂志,2011,19(5):465-466.
[10]王永华,李月,沈丽.114名听力筛查未通过的婴幼儿复诊结果分析[J].中医耳鼻喉科学研究杂志,2014,13(2):32-34.
[11]刘冬丽,侯书杨,余凤娟,等.脑干听觉诱发电位检测在新生儿高胆红素血症中的应用[J].中国实用神经疾病杂志,2016,4(19):109-110.
[12]冀飞,吴南.听神经病的诊断和干预[J].中国听力语言康复科学杂志,2017,15(1):61-66.
[13]吕静荣,黄治物,马衍,等.学龄前儿童迟发性听力损失筛查研究[J].听力学及言语疾病杂志,2013,21(3):221-224.
[14]王靖明,李洁,秦英,等.听力复查不通过的转诊婴儿听力学评估[J].中国耳鼻咽喉颅底外科杂志,2018,24(1):29-32.