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目的:观察高胆红素血症对不同胎龄早产儿听力的影响,探讨畸变产物耳声发射(DPOAE)检测技术对高胆红素血症早产儿听力筛查的意义。方法:对2011年1月至2012年12月沈阳市妇婴医院收治的256例不同胎龄的高胆红素血症早产儿(高胆红素血症组)及363例不同胎龄的血清总胆红素正常的早产儿(对照组)进行DPOAE测试,未通过者出生后42 d后复查,仍不能通过者于出生后3个月再次复查并行脑干诱发电位检查。结果:高胆红素血症组DPOAE初筛总通过率、复筛总通过率、第三次筛查总通过率及脑干诱发电位检查异常率与对照组相比,差异均有统计学意义(P<0.05)。高胆红素血症组中不同胎龄早产儿脑干诱发电位检查异常率比较,差异有统计学意义(P<0.05)。结论:高胆红素血症可引起早产儿听力障碍,胎龄越小影响越明显;DPOAE可作为筛查高胆红素血症早产儿听力障碍的基本方法。
Objective: To observe the effect of hyperbilirubinemia on the hearing of preterm infants of different gestational age, and to explore the significance of distortion product otoacoustic emissions (DPOAE) detection in hearing screening of premature infants with hyperbilirubinemia. Methods: A total of 256 pregnant women with hyperbilirubinaemia (hyperbilirubinemia group) and 363 pregnant women with different gestational age at different stages from January 2011 to December 2012 in Shenyang Maternal and Child Hospital were enrolled in this study. The DPOAE test was performed in preterm infants with normal total bilirubin (control group). Those who failed to pass the examination were reevaluated 42 days after birth, and those who failed to pass the test were re-examined for brain stem evoked potentials 3 months after birth. Results: There were significant differences in total DPOAE screening rate, total screening rate, total screening rate of third screening and abnormality of brainstem response in hyperbilirubinemia group compared with the control group (P <0.05). The abnormal rates of brainstem response in preterm infants with different gestational age in hyperbilirubinemia group were significantly different (P <0.05). CONCLUSION: Hyperbilirubinemia can cause hearing loss in preterm infants, and the more obvious the effect is when the gestational age is lower. DPOAE can be used as a basic method to screen the hearing impairment of premature infants with hyperbilirubinemia.