低出生体重对婴幼儿听力及言语发育的影响  

Effects of Low Birth Weight on Infants'Hearing and Speech Development

作　　者：平凯歌 耿曼英[1] 张慧[1] 王影 Ping Kaige;Geng Manying;Zhang Hui;Wang Ying(Department of Otolaryngology Head And Neck Surgery,The Second Affiliated Hospital of ZhengZhou University,Zhengzhou,450014,China)

机构地区：[1]郑州大学第二附属医院耳鼻喉科,郑州450014

出　　处：《听力学及言语疾病杂志》2021年第3期288-291,共4页Journal of Audiology and Speech Pathology

基　　金：河南省科技攻关计划普通项目(201702093);河南省科技攻关计划普通项目(201303084)。

摘　　要：目的探讨低出生体重儿的听力和言语发育状况,为该类婴幼儿的听力保健提供参考。方法87例极低出生体重儿(very low birth weight infants,VLBWI)、83例超低出生体重儿(extremely low birth weight infants,ELBWI)和90例正常出生体重儿(normal birth weight infants,NBWI)为研究对象,于新生儿出生后出院前一天采用自动听性脑干反应(AABR)进行听力筛查,筛查未通过者于3月龄时进行诊断性听性脑干反应(ABR)检查,ABR异常者进行听力评估,包括耳声发射、声导抗、ASSR、行为测听等检查,同时,对三组婴幼儿采用《婴幼儿听觉及言语发育观察表》及Gesell发育量表评估随访至18月龄,比较各组结果。结果AABR筛查未通过共80例(80/260,30.77%),其中,VLBWI组未通过33例(33/87,37.93%),ELBWI组未通过39例(39/83,46.99%),NBWI组未通过8例(8/90,8.89%),3组结果比较差异有统计学意义(P<0.05);3月龄时诊断性ABR异常8例,其中,VLBWI组3例(3/87,3.45%),ELBWI组5例(5/83,6.02%),NBWI组0例,三组比较差异有统计学意义(P<0.05)。最终确诊5例患儿双耳轻度听力下降,1例双耳中度听力下降,1例左耳重度听力下降、右耳极重度听力下降,1例双耳极重度听力下降。18月龄时VLBWI组发育商(olevelopmental quotieal,DQ)为86.56±4.58,ELBWI组为85.10±4.46,NBWI组94.31±4.57,前两组低于后者,差异有统计学意义(P<0.05)。结论低出生体重是新生儿听力损失的高危因素,可能延迟其言语发育,应加强随访,早发现,早诊治。Objective To study the effects of low birth weight on hearing and speech development of infants and young children,thus to provide a theoretical basis for hearing care of infants with low birth weight.Methods Eighty-seven cases of very low birth weight infants(VLBWI)and 83 cases of extremely low birth weight infants(ELBWI)born in our hospital,and 90 normal birth weight infants(NBWI)born in the same period infants were included in this study.Hearing screening was performed using automatic auditory brainstem response(AABR)one day before discharge,and those who failed the screening were diagnosed with brainstem auditory evoked potentials(ABR)at 3 months of age,followed by AABR for hearing follow-up.At the same time,the three groups of infants were evaluated for follow-up to 18 months of age using the Hearing and Speech Development Observation Chart for Infantsand Child Auditory and Speech Development and the Gesell Development Scale.Results Of 260 cases,80 cases(80/260,30.77%)AABR screening,failed in 33 cases(33/87,37.93%)VLBWI group,failed in 39 cases(39/83,46.99%)ELBWI group,failed in 8 cases(8/90,8.89%)NBWI group,the results of the three groups showed statistically significant differences(P<0.05).8 cases of diagnostic ABR at 3 months of age were abnormal.All 260 subjects had abnormal hearing in 8 cases,3 cases in VLBWI group(3/87,3.45%),and 5 cases in ELBWI group(5/83,6.02%),The results of the three groups showed statistically significant differences(P<0.05).The developmental quotient(DQ)of the 18-month-old VLBWI group was 86.56±4.58,the ELBWI group was 85.10±4.46,and the NBWI group was 94.31±4.57.The differences between the groups were statistically significant(P<0.05).Conclusion Low birth weight increases the hearing screening failure rate and delays the age of speech development.Follow-up should be strengthened,early detection,early diagnosis and treatment are recommended.

关 键 词：低出生体重儿 听力损失 高危因素 随访 

分 类 号：R339.16[医药卫生—人体生理学]