出生窒息对新生儿神经行为和听力的影响研究

摘要

目的：通过对窒息新生儿进行新生儿20项行为神经测定（ NBNA）及脑干听觉诱发电位（ BAEP）检查，评估窒息对新生儿的脑损伤情况。方法对2010年1月至2011年6月在广州市妇女儿童医疗中心就诊的51例窒息新生儿（窒息组）进行行为测定及脑干听觉诱发电位测定，并与同期因轻度呼吸系统、消化系统疾病住院的足月新生儿82例（对照组）的行为测定及脑干听觉诱发电位测定结果进行比较。结果窒息组7天NBNA总分36．32±1．28分，14天NBNA总分37．74±1．32分，对照组7天、14天NBNA总分均≥37分，两组比较差异均具有统计学意义（t值分别为10．15、4．49，均P＜0．05）；窒息组BAEP异常率35．29％，对照组BAEP异常率9．76％，差异具有统计学意义（χ2＝13．04，P＜0．05）；轻度窒息组BAEP异常率25．64％，重度窒息组BAEP异常率66．67％，差异有统计学意义（χ2＝6．76，P＜0．05）；窒息组中小于胎龄儿脑干听觉诱发电位异常发生率69．2％，适于胎龄儿异常率23．7％，差异有统计学意义（χ2＝8．80，P＜0．05）。结论新生儿窒息可以导致不同程度的脑损伤，因此对窒息新生儿进行神经行为及脑干听觉诱发电位检测可以用来评估脑功能及听力情况，为临床干预及预后提供客观依据。%Objective To estimate the cerebral injury caused by neonatal asphyxia in neonates by using neonatal behavioral neurological assessment ( NBNA) and brainstem auditory evoked potential ( BAEP ) test.Methods NBNA and BAEP test were conducted in 51 neonates who were hospitalized in Guangzhou Women and Children ’ s Medical Center during the period of January 2010 to June 2011 ( asphyxia group ) .Behavioral neurological assessment and BAEP of them were compared with those of 82 term neonates hospitalized because of mild respiratory system diseases and digestive system disease at the same period ( control group ) .Results NBNA scores were 36.32 ±1.28 at 7 day and 37.74 ±1.32 at 14 day in asphyxia group , while NBNA score was ≥37 at 7 day and 14 day in the control group.The differences between two groups were statistically significant (t value was 10.15 and 4.49, respectively, both P<0.05).The abnormal rate of BAEP was 35.29%in asphyxia group and 9.76%in control group.There was significant difference between them (χ2 =13.04, P<0.05).The abnormal rate of BAEP was 25.64% in mild neonatal asphyxia group and 66.67% in severe neonatal asphyxia group (χ2 =6.76,P<0.05).BAEP abnormal rate was 69.2%among small for gestational age neonates and 23.7%among appropriate for gestational age neonates in asphyxia group (χ2 =8.80, P<0.05).Conclusion Neonatal asphyxia can lead different degree of cerebral injury.Therefore, NBNA and BAEP test can be applied to estimate the function of brain and hearing , and thus provide objective basis for clinical intervention and prognosis .