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土耳其高危早产儿听力损失的产后相关风险因素:三级中心研究结果。

Postnatal risk factors associated with hearing loss among high-risk preterm infants: tertiary center results from Turkey.

机构信息

Developmental Behavioral Pediatrics Unit, Department of Neonatology, Zekai Tahir Burak Women Health and Education Hospital, Ankara, Turkey,

出版信息

Eur Arch Otorhinolaryngol. 2014 Jun;271(6):1485-90. doi: 10.1007/s00405-013-2653-3. Epub 2013 Aug 6.

Abstract

The aim of this study was to determine the postnatal risk factors associated with hearing loss as well as the prevalence of hearing loss among high-risk preterm infants in newborn hearing screening (NHS). We performed a retrospective study of high-risk preterm infants born with a gestational age ≤32 weeks and/or a birth weight ≤1,500 g. A NHS procedure was performed by automated auditory brainstem response (AABR) and automated evoked otoacoustic emission (TEOAE). Infants who failed TEOAE or AABR or both tests were referred to a tertiary audiology center for diagnosis confirmation and management. Postnatal risk factors associated with hearing loss were evaluated and compared for preterm infants with and without hearing loss. 1,360 high-risk preterm infants were assessed. Permanent hearing loss was found in 19 (1.4%) infants. Multivariate analysis revealed that proven sepsis (p = 0.019), mechanical ventilation ≥5 days (p = 0.024), loop diuretics (p = 0.001), patent ductus arteriosus ligation (p = 0.018) and operation for retinopathy of prematurity (ROP) (p = 0.034) were significant related factors for the hearing loss. This study showed a low prevalence of hearing loss and an association between operation for ROP and hearing loss in preterm infants, which has not been defined previously. Our results suggest that every neonatal intensive care unit should determine their own risk factors and take precautions to prevent hearing loss for these high-risk preterm infants.

摘要

本研究旨在确定与高危早产儿新生儿听力筛查(NHS)中听力损失相关的产后风险因素以及听力损失的患病率。我们对胎龄≤32 周和/或出生体重≤1500g 的高危早产儿进行了回顾性研究。通过自动听性脑干反应(AABR)和自动诱发耳声发射(TEOAE)进行 NHS 程序。TEOAE 或 AABR 或两项测试均失败的婴儿被转介到三级听力中心进行诊断确认和管理。评估并比较了有听力损失和无听力损失的早产儿的产后风险因素。评估了 1360 名高危早产儿。19 名(1.4%)婴儿发现永久性听力损失。多变量分析显示,确诊败血症(p=0.019)、机械通气≥5 天(p=0.024)、噻嗪类利尿剂(p=0.001)、动脉导管未闭结扎(p=0.018)和早产儿视网膜病变(ROP)手术(p=0.034)是听力损失的显著相关因素。本研究显示,早产儿听力损失的患病率较低,ROP 手术与听力损失之间存在关联,这以前尚未确定。我们的研究结果表明,每个新生儿重症监护病房都应确定自己的风险因素,并采取预防措施,防止这些高危早产儿发生听力损失。

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