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目的 探讨高胆红素血症新生儿及其与缺氧缺血性脑病 (HIE)、极低出生体重 (VLBW)分别或同时存在时的听力损伤特点,为早期治疗干预提供依据。方法 1998年 1月至 2004年 2月,选择广西医科大学第一附属医院新生儿科住院的 199例高胆红素血症新生儿为研究对象,将 199例 (398耳 )新生儿分为单纯高胆红素血症组、高胆红素血症 +HIE组、高胆红素血症 +VLBW组、高胆红素血症 +VLBW+HIE4组,对每组患儿予听性脑干诱发电位(ABR)检测。结果 高胆红素血症新生儿ABR总的反应阈为(57 12±21 53)dBnHL,总的异常率为 46 73%。当高胆红素血症与HIE、VLBW三种高危因素同时并存时,其异常发生率、重度异常发生率、平均反应阈均显著提高。结论 高胆红素血症与HIE、VLBW等高危因素分别或同时并存时,听损伤的机率相应增加,听损伤的程度也随之加重。此类患儿更应及早干预,重点随访。
Objective To investigate the characteristics of hearing impairment in neonates with hyperbilirubinemia and their relationship with hypoxic-ischemic encephalopathy (HIE) and very low birth weight (VLBW), respectively, and to provide basis for early treatment intervention. Methods From January 1998 to February 2004, 199 neonates with hyperbilirubinemia hospitalized in neonatology department of the First Affiliated Hospital of Guangxi Medical University were enrolled in this study. 199 cases (398 ears) of newborns were divided into simple high Bilirubin group, hyperbilirubinemia + HIE group, hyperbilirubinemia + VLBW group, hyperbilirubinemia + VLBW + HIE4 group, each group of children with auditory brainstem response Potential (ABR) detection. Results The total response threshold of ABR in newborns with hyperbilirubinemia was (57 12 ± 21 53) dBnHL and the total abnormal rate was 46 73%. When hyperbilirubinemia and HIE, VLBW three risk factors co-exist at the same time, the abnormal incidence, severe abnormalities, the average response threshold were significantly increased. Conclusions When hyperbilirubinemia and high-risk factors such as HIE and VLBW coexist respectively or simultaneously, the probability of hearing impairment increases correspondingly and the severity of hearing impairment also aggravates. Such children should be early intervention, focusing on follow-up.