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目的探讨新生儿重症监护病房(NICU)噪音对高危早产儿的听力损害。方法使用B&K2231精密积分声级计,累计测量NICU开放暖床及培育箱中噪音24 h,将其分为安静时间段和嘈杂时间段,记录其噪音分布情况。研究对象为早产极低出生体重儿,将培育箱中养育20例为观察组和开放暖床中20例为对照组。在住院1个月时,分别作瞬态诱发性耳声发射(TEOAE)和脑干听觉诱发电位(ABR)两项听力检查。结果安静时间段和嘈杂时间段时间比例约为3,安静时间段培育箱中噪音(55.3±1.2)dB与开放暖床中噪音(55.0±1.6)dB比较,P=0.179,差异无统计学意义;嘈杂时间段培育箱中噪音(58.6±3.3)dB与开放暖床中噪音(61.7±2.1)dB比较,P=0.000,差异有统计学意义。1个月龄时,做TEOAE和ABR检查,观察组总反应能量较对照组高1.5 dB SPL,P=0.033,差异有统计学意义;Ⅰ~Ⅴ波间期观察组缩短0.35ms,P=0.032差异有统计学意义;40例患儿均通过,各项指标显示观察组患儿优于对照组患儿。结论低噪音环境更有利于早产极低出生体重儿听觉系统发育。
Objective To investigate the hearing impairment of neonatal intensive care unit (NICU) noise in high-risk preterm infants. Methods The B & K2231 precision integrated sound level meter was used to measure the noise in NICU warm bed and incubator for 24 hours. It was divided into quiet period and noisy period, and the noise distribution was recorded. The subjects were preterm low birth weight infants, 20 cases of incubation in incubator and 20 cases of open bed in control group. At 1 month of hospitalization, two hearing tests, transient induced evoked otoacoustic emissions (TEOAE) and brainstem auditory evoked potentials (ABR), were performed. Results The ratio of quiet time to noisy time was about 3, and the noise in the incubator in quiet time was 55.3 ± 1.2 dB compared with 55.0 ± 1.6 dB in open warm bed, P = 0.179, the difference was not statistically significant (58.6 ± 3.3) dB in incubator during noisy period compared with 61.7 ± 2.1 dB in open warm bed, P = 0.000, the difference was statistically significant. At 1 month, TEOAE and ABR were performed. The total response energy of the observation group was 1.5 dB higher than that of the control group (P = 0.033), and the difference was statistically significant. The I ~ V wave interval observation group was shortened by 0.35 ms, P = 0.032 The difference was statistically significant; 40 cases of children were passed, the indicators showed that the observed group of children better than the control group of children. Conclusion Low-noise environment is more conducive to preterm low birth weight infants with auditory system development.