新生儿及婴儿期腭裂患儿分泌性中耳炎的发病情况  

Incidence and natural history of middle ear disease in newborns and infants with cleft palate

作　　者：李薇[1] 尚伟[2] 于爱华[1] 张哓恒[1] 刘玉欣[3] 张秋贵[1] 

机构地区：[1]青岛大学医学院附属医院耳鼻咽喉科,山东青岛266003 [2]青岛大学医学院附属医院口腔颌面外科 [3]青岛市妇女儿童医疗保健中心耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第7期296-298,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：人事部留学回国基金资助项目(No:2001-119);青岛市科技发展指导计划基金资助项目(No:2000-01-43)

摘　　要：目的：了解新生儿及婴儿期腭裂患儿发生分泌性中耳炎（SOM）和听力损失情况，探讨其中耳功能障碍的发病时间规律及SOM早期预测方法。方法：出生后1～2周行听性脑干反应（ABR）筛查，无感音神经性聋的73例新生儿及婴儿腭裂患儿，在婴儿期于每月龄末行ABR和声导抗检查。结合鼓室导抗图形、静态声顺值、镫骨肌声反射和ABR波V阈值作为SOM的判断指标；以ABR波V阈值作为2～4kHz范围的听损伤分级标准。结果：73例（146耳）腭裂患儿发生疑似SOM，发生率为100％，均于出生后6个月内发生，平均发生年龄为2．5月龄。其中115耳（78．8％）1岁内发生SOM，平均发病年龄为5．4月龄，出生后6个月时为相对发病高峰期；SOM的前驱期平均为3．8个月。婴儿期腭裂患儿56．2％会出现不同程度的听力损伤，ABR波V阈值平均为48．6dBnHL。结论：婴儿期腭裂患儿SOM发病率高，可引起听力损失，严重影响中耳功能，其发生呈渐进性过程；作为发生中耳功能障碍的高危人群，出生后1个月时应行听力检查，每2～3个月定期复查，无条件者至少6～12个月进行耳科检查，以早期发现、及时诊断。Objective：The aim of this study is to investigate the incidence and natural history of secretory otitis media（SOM） and hearing loss in newborns and infants with cleft palate, consequently, define its audiological criteria and to predict SOM early, Method： Seventy-three newborns and infants with a cleft palate （146 ears） were monthly estimated by tympanogram, static compliance, acoustic stapedius reflex and auditory brainstem response （ABR） under natural sleep within one year of age. Result： Au the infants with cleft palate had the suspected SOM in the first 6 months of life. Among children with cleft palate, the suspected SOM were most prevalent in the 3- month-age. 78.8% infants with cleft palate had the confirmed SOM in the first 12 months of life. SOM were most prevalent in the 6-month-age. The SOM prodromal period was averagely 3.8 months from suspected SOM to confirmed SOM. 56.2% infants with cleft palate had a conductive hearing loss in the first 12 months of life. The conduction hearing thresholds of ABR （2-4 Hz） were averagely 48.6 dBnHL. Conelusion：The highest incidence of SOM and hearing loss in children with cleft palate appear in infants in the first 1 year of life. The process of SOM and hearing loss onset is progressive process. The infants with cleft palate should be estimated by ABR and acoustic immitance audiometry in each period of 2 or 3 months after birth.

关 键 词：新生儿 婴儿 腭裂 中耳炎 伴渗出液 听力损失 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]