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目的观察卡铂在化疗过程中对视网膜母细胞瘤患儿的听力损伤及其严重程度。设计回顾性病例系列。研究对象选择自2009年11月至2011年2月在我院进行卡铂(carboplatin)、依托泊苷(etoposide)、长春新碱(vincristine)方案化疗的视网膜母细胞瘤患者111例,排除相关因素后95例患者(135眼)入选。方法分别在第1、3、6次化疗前进行与年龄相匹配的听力学检查,包括纯音测听(pure-tone audiometry)检查、畸变产物耳声发射(distortion-product otoacoustic emission,DPOAE)检查、听力脑干诱发电位(auditory brainstem response,ABR)检查等。观察化疗过程中双耳听力阈值的变化情况,并判断是否有听力损害。主要指标听力阈值。结果进行化学治疗的平均疗程为5.4次(3~10次)。化疗过程中,95例患者中仅3例出现听力检查结果的异常,其中2例在随后的复查中双耳阈值恢复正常,1例在3次随访听力检查中均提示左耳阈值提高。结论卡铂对视网膜母细胞瘤化疗患者的听力损伤并不常见,程度较轻,但对患儿进行听力监测十分必要。
Objective To observe the severity of hearing loss and the severity of carboplatin in children with retinoblastoma during chemotherapy. Design retrospective case series. Subjects selected from November 2009 to February 2011 in our hospital for carboplatin, etoposide (etoposide), vincristine regimen of retinoblastoma patients 111 cases, excluding the relevant factors After 95 patients (135 eyes) were enrolled. Methods The age-matched audiological tests were performed before the first, the third and the sixth chemotherapy, including pure-tone audiometry, distortion-product otoacoustic emission (DPOAE) Auditory brainstem response (ABR) examination and so on. Observe the change of hearing threshold during the course of chemotherapy and judge whether there is hearing loss. The main indicators of hearing threshold. Results The average duration of chemotherapy was 5.4 (3 to 10). During the course of chemotherapy, only three of the 95 patients had abnormal hearing tests, two of which returned to normal in the subsequent review, and one in three of the follow-up audiograms, suggesting an increase in left-ear threshold. Conclusion Carboplatin is not common and mild to patients with retinoblastoma, but it is necessary to monitor hearing in children.