摘要
目的探讨儿童期细菌性脑膜炎致听觉损伤的预后及其危险因素。方法系统回顾分析2011年6月至2013年5月在乌鲁木齐儿童医院确诊为细菌性脑膜炎的63例住院患儿的临床资料，及脑干听觉诱发电位（BAEP）检测结果和随访结果，比较BAEP异常组与BAEP正常组患儿问发病至受检时间、CRP结果、民族、性别、年龄及脑脊液（CSF）检测结果。结果BAEP受检50例患儿中22例存在单耳或双耳轻重不等的异常，异常率为44％，其中单耳听路异常6例（左耳4例，右耳2例），双耳异常16例。21例为周围性听路损害伴听力异常；1例为脑干中枢性听路损伤。对16例（26耳）BAEP异常患儿于出院后1～6个月进行随访，其中3例患儿4耳重度听觉损伤者无恢复，最终成为感应性神经性耳聋。BAEP异常组患儿发病至受检时间、CRP结果、民族、性别与BAEP正常组比较，差异均无统计学意义（P均〉0．05）；而BAEP异常组CSF白细胞计数≥1000×10^6／L（18例）、蛋白≥1．5g／L（15例）、葡萄糖≤1．0mmol／L（11例）及年龄≤1岁（18例）例数均较BAEP正常组（分别为14例、9例、5例、14例）高，差异均有统计学意义（X2=5．14、6．42、5．85、5．41，P均〈0．05）。结论听觉损害是细菌性脑膜炎常见的并发症，重度听觉损伤常难以恢复。患儿年龄及CSF白细胞计数、蛋白和葡萄糖水平是影响细菌性脑膜炎听觉损害的危险因素。尽早对细菌性脑膜炎患儿进行BAEP检测并定期复查十分重要。
Objective To explore the prognosis and risk factors of the hearing damages caused by bacterial meningitis in children. Methods A systematic retrospective analysis was carryed out based on their clinical data, the brainstem auditory evoked potential （BAEP） test and follow-up evaluation in 63 pediatric patients diagnosed with bac- terial meningitis from Jun. 2011 to May 2013 in Urumqi Children＇s Hospital. The duration from onset to the first BAEP test, CRP results, ethnics, genders, age white blood cell count, protein and glucose levels in cerebros pinal fluid （CSF） were compared between the BAEP abnormal group and BAEP normal group. Results Fifty children were detected by BAEP. The hearing damage at single or both ears with different severity were found in 22 cases, so the incidence of ab- normanity was 44%. Six cases in which were suffered from auditory pathway disorders at a single ear,including 4 cases in left ears, and 2 cases in right ears, while 16 cases were in both ears. Among them, peripheral auditory pathway dama- ges with hearing abnormalities were found in 21 cases. Central auditory pathway damage of brainstem was found only in 1 case. Sixteen cases with BAEP abnormalities were followed up in 1 -6 months. Four ears of 3 cases with severe hea- ring damages were not improved and eventually became paratonic sensorineural hearing loss. There was no difference of the duration from onset to the first BAEP test, CRP results, ethnics and genders between the BAEP abnormal group and BAEP normal group （all P 〉0.05）. However,in BAEP abnormal group,the cases of white blood cell count≥1000 × 106/L （ 18 cases）, protein ≥ 1.5 g/L （ 15 cases）, glucose levels ≤ 1.0 mmol/L （ 11 cases ）, in CSF age ≤ 1 year old （ 18 cases） were significantly higher those in BAEP normal group （ 14 cases, 9 cases,5 cases, 14 cases, respectively） （X2= 5. 14,6. 42,5. 85,5. 41, all P 〈 0.05 ）. Conclusions Hearing damages are common complications of the bacterial meningitis in children, and severe hearing damages may difficult to recover in the early stage. The risk factors of hearing damages caused by the bacterial meningitis in children are age, white blood cell count, protein and glucose levels in CSF. It is quite important to finish the early BAEP tests and follow up at regular intervals for bocterial menin- gitis in chindren.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第24期1875-1877,共3页
Chinese Journal of Applied Clinical Pediatrics
关键词
细菌性脑膜炎
脑干听觉诱发电位
听觉损害
临床特点
儿童
Bacterial meningitis
Brainstem auditory evoked potential
Hearing damage
Clinical features
Child
