重度黄疸换血新生儿的脑干听觉诱发电位影响因素分析  

Study on the influence factors of brainstem auditory evoked potential in newborns underwent exchange transfusion due to severe hyperbilirubinemia

作　　者：徐倩倩 刘耿耿 王富明 唐军 储进 Xu Qianqian;Liu Genggeng;Wang Fuming;Tang Jun;Chu Jin(E.N.T.department,Kaifeng Children'Hospital,Kaifeng,Henan,475000,China;electroencephalogram room,Kaifeng Children'Hospital,Kaifeng,Henan,475000,China;neonatology department,Kaifeng Children'Hospital,Kaifeng,Henan,475000,China)

机构地区：[1]开封市儿童医院耳鼻喉科,河南开封475000 [2]开封市儿童医院脑电图室,河南开封475000 [3]开封市儿童医院新生儿科,河南开封475000

出　　处：《齐齐哈尔医学院学报》2023年第10期946-949,共4页Journal of Qiqihar Medical University

基　　金：开封市科技发展计划项目(2203112,2003108)。

摘　　要：目的分析需动静脉换血治疗的重度黄疸新生儿的脑干听觉诱发电位(BAEP)情况,了解进行换血治疗的重度黄疸新生儿脑干听觉诱发电位异常率、导致BAEP异常的可能相关因素,以便在围生期加强关注、及早进行干预、降低听力损害发生率等不良后果。方法回顾性分析2019年1月—2021年12月本院新生儿病区住院的新生儿病历资料,检索出成功开展换血治疗的重症黄疸新生儿且进行脑干听觉诱发电位检查的患儿,记录患儿脑干听觉诱发电位结果、一般资料、胎龄、体重、换血时日龄、换血前及换血后血清总胆红素水平、直接胆红素水平、住院天数等情况,并根据BAEP结果分为脑干听觉诱发电位异常组和脑干听觉诱发电位正常组两组进行对比。结果共找到91例符合条件的重度黄疸换血并进行脑干听觉诱发电位检查的新生儿,其中5例进行第2次换血,共进行96例次换血治疗,91例BAEP检查中脑干听觉诱发电位异常患儿27例(29.7%)、正常患儿64例(70.3%)。在BAEP异常组新生儿换血前血清总胆红素(TSB)水平[(462.76±128.34)μmol/L]、换血前直接胆红素(DB)水平[(28.24±16.46)μmol/L]、换血时日龄[(6.26±3.50)天]均分别高于BAEP正常组新生儿换血前血清总胆红素水平[(408.12±101.85)μmol/L]、换血前直接胆红素水平[(21.20±6.94)μmol/L]、换血时日龄[(4.16±3.04)天],组间差异均有统计学意义(P<0.05)。脑干听觉诱发电位异常组的新生儿换血后血清总胆红素水平[(229.56±60.86)μmol/L]、换血后直接胆红素水平[(23.07±10.01)μmol/L]、患儿胎龄[(38.92±1.59)周]、体重[(3.042±0.559)千克]与BAEP正常组新生儿换血后血清总胆红素(TSB)水平[(223.97±54.38)μmol/L]、换血后直接胆红素(DB)水平[(21.84±18.97)μmol/L]、患儿胎龄[(39.23±1.21)周]、体重[(3.243±0.413)千克]相比,组间差异均均无统计学意义(P>0.05)。BAEP异常组的新生儿住院天数[(10.89±4.62)天]�Objective We analyzed the situation of brainstem auditory evoked potential(BAEP)of children with hyperbilirubinemia those received peripheral arteriovenous exchange transfusion,then find out the abnormal rate of BAEP and possible related factors which leading to the abnormal result of children with severe neonatal hyperbilirubinemia.Finally we can strengthen the attention in the perinatal period and give early intervention then reduce the possible hearing impairment.Methods The case data of newborns those were admit to the neonatal ward of our hospital from January 2019 to December 2021 were retrospectively analyzed.The children,suffered from severe hyperbilirubinemia those underwent peripheral arteriovenous exchange transfusion successfully and brainstem auditory evoked potential detection,were screened out.The data such as brainstem auditory evoked potential result,general information,gestational age,weight,the age when receiving exchange transfusion,the level of serum total bilirubin and direct bilirubin before and after receiving exchange transfusion,hospitalization days were recorded.All newborns were divided into the normal brainstem auditory evoked potential group and the abnormal brainstem auditory evoked potential group according to the BAEP result and the two groups were compared.Results A total of 91 cases meet the standard and 5 of whom receive a second exchange transfusion,thus the newborn underwent 96 times of exchange transfusion.All the newborn receive brainstem auditory evoked potential,27 cases(29.7%)of which are abnormal and 64 cases(70.3%)are normal.In abnormal BAEP group serum total bilirubin level and direct bilirubin level before exchange transfusion,age of exchange transfusion when receiving exchange transfusion,the length of hospital stay were higher/longer than those in the normal group[(462.76±128.34)μmol/L,(28.24±16.46)μmol/L,and(6.26±3.50)days vs(408.12±101.85)μmol/L,(21.20±6.94)μmol/L,(4.16±3.04)days],with statistically significant respectively(P<0.05).There were no statist

关 键 词：新生儿黄疸 换血 脑干听觉诱发电位 

分 类 号：R722.1[医药卫生—儿科]