早产儿听力筛查结果及其听力障碍危险因素

doi:10.6040/j.issn.1673-3770.0.2014.386

摘要/Abstract

摘要： 目的分析新生儿重症监护中心(NICU)中早产儿的听力筛查结果, 探讨导致早产儿听力障碍的高危因素。方法回顾性分析821 例不同胎龄早产儿的一般资料及听力筛查数据, 对听力筛查未通过的危险因素加以总结。结果 821 例中听力初筛未通过率61.0%, 复筛未通过率为 16.0%, 出生后 3 个月自动听性脑干反应(AABR)总未通过率为 9.4%。初筛、复筛及AABR检查未通过率及听力障碍程度随胎龄的增大呈依次降低的趋势。多因素Logistic 回归分析表明, 极低出生体质量、高胆红素血症、感染和窒息是听力初筛和复筛听力障碍的危险因素, 胎龄 > 32 周为听力初筛听力障碍的保护因素(OR=0.499, P=0.022), 极低出生体质量为听力复筛听力障碍独立危险因素(OR=2.385, P=0.038)。结论早产儿由于机体各组织器官发育不成熟, 听力障碍高发, 胎龄越小听力损伤发生危险性越高, 听力障碍与出生体质量、高胆红素血症、感染和窒息有关, 应该对早产儿听力进行早期监测并及时随访。

关键词: 听力障碍, 听力筛查, 新生儿重症监护中心, 危险因素, 早产儿

Abstract: Objective To investigate the risk factors of hearing impairment by analyzing the results of hearing screening in the premature infants in the neonatal intensive care unit. Methods A total of 821 premature infants, admitted to the neonatal intensive care unit form January 2010 to December 2013, were screened for hearing functions. The risk factors for no passing in the screenings were analyzed. Results The failure rates in initial and secondary screening were 61.0% and 16.0%, respectively. The failure rate was 9.4% in the automatic auditory brainstem response (AABR) test conducted at three months after birth. With the growth of gestational age, pass rate increased and degree of hearing disorders decreased in the mean time. Logistic regression analysis showed that very low birth weight, hyperbilirubinemia, infection and suffocation were risk factors for hearing, while, gestational age > 32 weeks was protective factor (OR=0.499, P=0.022). Low birth weight was independent risk factor for hearing screening and hearing impairment (OR=2.385, P=0.038). Conclusion Due to immature development, premature babies suffer from high incidence of hearing loss. The smaller the gestational age is, more commonly hearing damages occur. Low birth weight, hyperbilirubinemia, infections are risk factors for hearing impairment. Early detection and timely follow-up are neccessary.

Key words: Neonatal intensive care center, Premature infant, Risk factor, Hearing screening, Hearing impairment

中图分类号:

R764.4

王国强, 赵春红, 霍红, 龚志云, 宋伟伟, 严丽霞, 李雪华, 王伟丽. 早产儿听力筛查结果及其听力障碍危险因素[J]. 山东大学耳鼻喉眼学报, 2015, 29(4): 7-10.

WANG Guoqiang, ZHAO Chunhong, HUO Hong, GONG Zhiyun, SONG Weiwei, YAN Lixia, LI Xuehua, WANG Weili. Hearing screening and risk factors of hearing impairment in premature infants.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(4): 7-10.

参考文献

[1] Erenberg A, Lemons J, Sia C, et al. Newborn and infant hearing loss: detection and intervention. American Academy of Pediatrics. Task Force onNewborn and Infant Hearing, 1998- 1999[J]. Pediatrics, 1999, 103(2):527-530.
[2] Jiang Z D, Zhou Y, Ping L L, et al. Brainstem auditory response findings in late preterm infants in neonatal intensive care unit[J]. Acta Paediatr, 2011, 100(8):51-54.
[3] Halpin K S, Smith K Y, Widen J E, et al. Effects of universal newborn hearing screening on an early intervention program for children with hearing loss, birth to 3 yr of age[J]. J Am Acad Audiol, 2010, 21(3):169-175.
[4] American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs[J]. Pediatrics, 2007, 120(4):898-921.
[5] 陶方英,龚正鹏.TEOAE与AABR在高危新生儿听力筛查中的联合应用[J].中华耳科学杂志,2013,11(2):235-238.
TAO Fangying, GONG Zhengpeng. TEOAE with AABR joint application in high-risk newborn hearing screening[J]. Chin J Otology, 2013, 11(2):235-238.
[6] 黄治物.婴幼儿听力损失的早期诊断评估及干预*(4)[J].听力学及言语疾病杂志,2013,21(5):561-562.
HUANG Zhiwu. Evaluation of early diagnosis of hearing loss in infants and relevant intervention *(4)[J]. J Audiol Speech Pathol, 2013, 21(5):561-562.
[7] 邓忠,罗铭华,董运鹏,等.郴州市121352例新生儿听力筛查结果分析[J].听力学及言语疾病杂志,2014,22(3):306-308.
DENG Zhong, LUO Minghua, DONG Yunpeng, et al. On the Results of Hearing Screening among newborns in the city of chen zhou[J]. J Audiol Speech Pathol, 2014, 22(3):306-308.
[8] 庄帝钱,赵芳,李耀武, 等.不同新生儿危重症评分对极低出生体质量儿永久致残的预测价值[J]. 广东医学,2013,34(15):2314-2317.
ZUANG Diqian, ZHAO Fang, LI Yaowu. et al. Different neonatal critical care scoring very low birth weight infant permanently disabled the predictive value[J]. Guangdong Med, 2013, 34(15):2314-2317.
[9] 宋文萍,晋芙莉.极低出生体质量儿159例临床分析[J]. 中国妇幼健康研究,2013,24(4):563-564,599.
SONG Wenping, JIN Fuli. Clinical analysis of 159 cases of very low birth weight infants[J]. Chin J Woman Child Health, 2013, 24(4):563-564,599.
[10] Neocleous C, Adramerina A, Limnaios S, et al. A comparison between transcutaneous and total serum bilirubin in healthy-term greek neonates with clinical jaundice[J]. Prague Med Rep, 2014, 115(1-2):33-42.
[11] Mesić I, Milas V, Medimurec M, et al. Unconjugated pathological jaundice in newborns[J]. Coll Antropol, 2014, 38(1):173-178.
[12] Xia Y F, Liu C Q, Li H X, et al. Investigation of risk factors for hearing impairment in premature infants[J]. Zhongguo Dang Dai Er Ke Za Zhi, 2013, 15(12):1050-1053.
[13] 王丽.围生期巨细胞病毒感染监测与预后评估[J].国际儿科学杂志,2012,39(3):237-241. WANG Li. Monitoring and prognosis of perinatal Cytomegalovirus infection assessment[J]. J Inter Paediat, 2012, 39(3):237-241.
[14] 梁玲芳.婴儿巨细胞病毒感染致听力受损的研究进展[J]. 国际儿科学杂志,2010,37(5):475-478. LIANG Lingfang. Infant hearing loss caused by Cytomegalovirus infection progress[J]. J Inter Paediat, 2010, 37(5):475-478.
[15] 杨崇玲,叶清,王幼勤,等.窒息新生儿与正常新生儿听力筛查结果分析[J].听力学及言语疾病杂志,2010,18(6):549-552. YANG Chongling, YE Qing, WANG Youqin, et al. Asphyxia with normal newborn hearing screening results analysis[J]. J Audiol Speech Pathol, 2010, 18(6):549-552.
[16] 李永奇,丁大连,蒋海燕,等.速尿引起的小鼠耳蜗血管纹缺血缺氧性病变[J].中国中西医结合耳鼻咽喉科杂志,2010,18(3):123-127. LI Yongqi, DING Dalian, JIANG Haiyan, et al. Furosemide-induced cochlear stria vascularis of hypoxic-ischemic lesion[J]. Chin J Otorhinolaryngol Integ Med, 2010, 18(3):123-127.

相关文章 15

[1]	王焕霞,王淑雅,王影,孙璇,黄杰,王兴荣. 孔源性视网膜脱离玻璃体切除术后继发黄斑前膜的危险因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 181-185.
[2]	陈铭,柯冰冰,崔雅琦,吴翠萍,陈正侬,李春燕,殷善开. NAD⁺对顺铂所致毛细胞氧化应激损伤的拮抗作用及相关基因表达调控[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 11-18.
[3]	张国明,魏文斌,林浩添,迟玮,张少冲,赵培泉,雷柏英,陈有信,王雨生,何明光,梁建宏,卢海,陆方,黄欣,梁小玲,赵欣予,吴桢泉,余震,崔凯璇,刘亚玲,项道满,陈长征,张自峰,林铎儒,于珊珊,孙悦,檀韬,陈燕先,彭婕,董力,程湧,朱雪梅,杨鹏,陈少滨. 人工智能技术辅助早产儿视网膜病变诊疗专家共识(2025)[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 1-5.
[4]	张琳,辛运超,尚小领,解琪,刘亚超. cN0期甲状腺微小乳头状癌颈部中央区及侧颈区淋巴结转移率、危险因素及清扫策略的临床研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 62-69.
[5]	张晓,刘海红,刘薇,李颖,陈敏,刘冰,白杰,张杰,郑军,杨扬. 先天性单侧聋患儿112例临床资料分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 96-196.
[6]	胡亚柔,赵欣予,吴桢泉,范梓欣,余震,刘亚玲,陈婷毅,曾键,张国明. 早产儿屈光状态与眼部生物特征的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 144-150.
[7]	索安奇,孙聚兴,牛红燕,周艳秋,牛鹏昊,毛文伟,李晓瑜,杨欣欣. 耳部钢筋复杂穿刺伤救治1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 79-83.
[8]	孟素坤,张纯. 小梁消融术治疗开角型青光眼患者的长期视野缺损研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 139-148.
[9]	李璐,赵杰,赵博军. 中心性浆液性脉络膜视网膜病变的发病机制与治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 118-124.
[10]	杜曰山一,王鲜,张国明. 人工智能辅助早产儿视网膜病变诊疗新进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 157-162.
[11]	李为,赵毅,葛玥铭,付洪涛,王进东,张晓龙,董洁,程钰翔. 双卵双胎和单卵双胎新生儿听力筛查结果分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 1-6.
[12]	李智林,郑洲,安韡. 12例原发性甲状腺鳞状细胞癌的临床及生存分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 59-63.
[13]	肖富亮,林云,潘新良. 早期cN0 PTC预防性中央区淋巴结清扫的临床研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 64-71.
[14]	李爱军,崔小梅. 白内障术前房颤人群综合路径管理现状横断面调查[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 38-44.
[15]	张礼俊, 胥然, 罗继芳, 刘国旗, 何千, 李玮, 蒋振华. 头颈肿瘤游离皮瓣修复术后皮瓣坏死及皮瓣相关并发症影响因素分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 86-90.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed