脑性瘫痪患儿听力学特征118例分析  

Measurement and investigation of audiology in 118 infants with cerebral palsy.

作　　者：刘清明[1] 朱蓉[1] 郭幸[1] 李东英[1] 蔡海青[1] 陈田[1] 周炎荣[1] 赖碧云[1] 郑巧娥[1] 

机构地区：[1]珠海市妇幼保健院儿保科听力筛查中心,广东珠海519000

出　　处：《中国儿童保健杂志》2006年第4期352-354,共3页Chinese Journal of Child Health Care

摘　　要：[目的]分析脑性瘫痪患儿听功能改变特点及听觉脑干诱发电位（auditory brainstem response,ABR）、畸变产物耳声发射（distortion product otoacoustic emission,DPOAE）测试的意义及应用价值.[方法]对4岁以下118例脑性瘫痪患儿进行ABR测试,与各年龄组正常标准值比较,并对异常ABR患儿同时进行DPOAE测试,与标准值比较.[结果]118例脑瘫患儿经ABR测试各波反应阈在正常范围76例（64.4%）,异常42例（35.6%）.在42例听损伤患儿中双耳听损伤33例,单耳听损伤9例.双耳重度以上听损伤27例,中度、轻度听损伤各3例.单耳均为轻度听损伤9例.在42例听损伤患儿中未引出波形18例,均为重度脑瘫患儿;14例Ⅰ波峰潜伏期延长;13例Ⅰ～Ⅲ峰间期延长,10例Ⅲ～Ⅴ峰间期延长.对42例ABR测试异常患儿行DPOAE检查,其中双耳听损伤33例中,有4例双耳DPOAE反应缺失,与ABR检查结果一致,考虑为双侧耳蜗性听损伤;28例双耳DPOAE大致正常,而ABR波形异常,考虑为双侧蜗后性听损伤.1例双耳轻度听损伤患儿和9例单耳轻度听损伤患儿DPOAE幅值高频区下降,考虑为蜗性高频区听损伤.14例为蜗性听损伤,28例为蜗后性听损伤.[结论]脑性瘫痪患儿听功能改变以双侧性、重度性、神经性听损伤为特点,主要为耳蜗后听路损害.ABR、DPOAE对于脑瘫患儿的听力损害提供客观定位和频率特性.[Objective] To study the characteristics of evoked audiology in infants with cerebral palsy（CP）, and evaluate the role of auditory brainstem response （ABR）/distortion product otoacoustic emission （DPOAE） in hearing diagnosis for CP. [Methods] ABR was measured in 118 infants aged 0-4 years with CP and the diagnostic efficiency of DPOAE was evaluated in 42 children with hearing disorders. [Results] Among 118 cases, 42 cases hearing disorder were founded ,including 33 cases both ears hearing disorder, 9 cases with one ear hearing disorder. There were 27 cases of high hearing disorder, 3 cases of low and middle hearing disorder. 42 cases of hearing disorder were tested by DPOAE, and the accuracy of DPOAE were 4 cases respectively. The amplitude and S/N-ratio in infants with CP were obviously lower than those of normal neonates. The results of DPOAE and ABR were separated in 28 cases. [Conclusion] High and both ears hearing disorder are characteristics of evoked audiology in infant with CP and the frequency specificity of DPOAE is valuable for hearing evaluation and helpful for hearing aids to infants with CP.

关 键 词：脑性瘫痪 听觉脑干诱发电位 畸变产物耳声发射 新生儿 

分 类 号：R174.2[医药卫生—妇幼卫生保健]