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目的:探讨高原地区缺氧缺血性脑病(HIE)对新生儿听力的影响,尽早发现听力障碍,早诊断、早治疗。方法:采用瞬态诱发耳声发射(TEO-AE),对2006年7月—2007年6月期间我院NICU中住院的186例缺氧缺血性脑病病情趋于稳定的患儿和186例在我院产科出生的正常新生儿(对照组)进行听力筛查。对TEOAE异常者给予脑干听觉诱发电位(BAEP)检测。BAEP异常者,尽早医学干预,并定期随访3个月。结果:186例HIE,TEOAE异常者82例,异常率为46.08%;对照组186例,TEOAE异常者为36例,异常率为3.23%。186例HIE,BAEP随访18例,1个月时异常4例(22.22%),2个月后异常3例(16.67%),3个月后异常1例(5.00%)。较我国其他省份筛查结果比稍偏高,其他省为(2.7~3.0)%,被确诊为单耳轻度听力障碍。对照组5例TEOAE异常者BAEP均正常。结论:HIE可致新生儿听力障碍,HIE病情越重,BAEP异常率越高。但随着HIE病情好转,听力障碍也逐渐好转。
Objective: To investigate the effect of hypoxic-ischemic encephalopathy (HIE) on the hearing of newborn infants in the plateau area, and to detect hearing loss as soon as possible, diagnose early and treat early. Methods: Transient evoked otoacoustic emissions (TEO-AE) were used to evaluate the clinical efficacy of TEO-AE in 186 children hospitalized with NICU in our hospital from July 2006 to June 2007, and 186 patients with stable hypoxic-ischemic encephalopathy Hearing screening was performed in normal neonates born in obstetrics and gynecology (control group). Patients with abnormal TEOAE were given brainstem auditory evoked potentials (BAEP). Abnormal BAEP, medical intervention as soon as possible, and regular follow-up of 3 months. Results: There were 82 cases with abnormal HIE and TEOAE in 186 cases, the abnormal rate was 46.08%. In the control group, 186 cases had abnormal TEOAE, and the abnormality rate was 3.23%. There were 186 cases of HIE and 18 cases of BAEP. There were 4 cases (22.22%) at 1 month, 3 cases (16.67%) after 2 months and 1 case (5.00%) after 3 months. Compared with other provinces in China, the screening results slightly higher than the other provinces (2.7 ~ 3.0)%, was diagnosed with monaural mild hearing loss. The control group, 5 cases of TEOAE abnormal BAEP were normal. Conclusion: HIE can cause neonatal hearing impairment, the more severe the HIE, the higher the abnormal rate of BAEP. However, with the improvement of HIE, hearing impairment gradually improved.