新生儿重症监护病房噪音对早产儿听力影响的研究  

The noise effect on hearing loss of preterm infants in the neonatal intensive care unit

作　　者：王莹[1] 张巍[1] 李兴启[2] 孙惠红[1] 

机构地区：[1]首都医科大学附属北京妇产医院新生儿重症监护病房,100026 [2]解放军总医院耳鼻喉科研究所

出　　处：《中国新生儿科杂志》2009年第6期346-349,共4页Chinese Journal of Neonatology

摘　　要：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 damage of hearing by noise in high risk premature infants in the neonatal intensive care unit （NICU）. Methods The use of B ＆ K2231 integral precision sound level meter to measure the accumulative noise of crib and incubator in NICU ward within 24-hour, which were divided into the quiet and noisy time period, and record the noise distribution; the very low birth weight premature infants was divided into two groups- 20 cases of incubator for the Observer Group/ 20 cases of crib in the control group respectively. In one month time. transient evoked otoacoustic emissions （TEOAE） and the brain stem auditory evoked potential （ABR） hearing test were performed. Results The time ratio of quiet time vs noisy time was 3, the comparison of noise at the quiet time between the incubator （55.3 ± 1.2 ） dB and the crib （55.0 ± 1.6 ） dB was P = 0. 179, no statistic significant; the comparison of noise at the noisy time -incubator （58.6 ± 3.3） dB and crib （61.7 ± 2. 1 ） dB was P = 0. 000, this is a statistic significant ; in one month time, for TEOAE and ABR examination, 40 patients were adopted, the indicators showed that more children in the observation group than in the control group, with significant increasing 1.5 dB SPL at response energy （ P = 0. 033 ） and with shorting of 0. 35 ms between Ⅰ - Ⅴinterval peak latency （P = 0. 032）. Conclusion Low-noise environment was found more beneficial to the development of the auditory system of the very low birth weight premature infants. At the same time, the need for more cases and longer time of follow-up will be more ideal to come to such a conclusion.

关 键 词：重症监护病房 新生儿 听力 噪音 

分 类 号：R764[医药卫生—耳鼻咽喉科]