目的 通过分析比较婴幼儿听力正常组,听神经病(AN)组和极重度感音神经性聋组在耳蜗微音电位(CM),耳声发射(OAE)的引出率以探讨经表皮电极测得耳蜗微音电位在诊断婴幼儿听神经病中的应用价值.方法 选取年龄3月龄至36月龄的婴幼儿,根据听力结果和影像学检查的结果综合分析,其中听力正常组50人100耳,AN组25人49耳,极重度感音神经性聋组40人75耳,比较三组研究对象的耳声发射和耳蜗微音电位的引出率有无统计学意义.结果 OAE在听力正常组中的引出率是91％,在AN组中的引出率是75.5％,在极重度感音神经性聋组中的引出率是0;CM在听力正常组中的引出率是96％,在AN组中的引出率是100％,在极重度感音神经性聋组的引出率是0;分别进行OAE和CM的引出率的两两比较,听力正常组与AN组在OAE的引出率无统计学差异(P=0.531>0.05),听力正常组与AN组CM的引出率也无统计学差异(P=0.578>0.05),而AN组与极重度神经性聋组以及听力正常组与极重度神经性聋组OAE和CM的引出率差异均具有统计学意义(P=0.00<0.05).结论 CM和OAE都是评价耳蜗外毛细胞功能的客观听力学检查方法,由于CM可避免中耳功能的影响,因此在婴幼儿听力检查中比OAE更精准,尤其是当ABR在100nHL未引出或严重异常时,CM应当作为一项常规的检查项目来诊断婴幼儿听神经病.

Objective To explore the relationship between the results of distortion product otoacoustic emission(DPOAE)and the hearing results,and to provide correct theoretical support for the health education of the parents.Methods Drawn from our hearing center in random,304 cases who were not passed the test of early screening or compound sieve one ear or two ears were accepted comprehensive hearing examination,namely acoustic immittance,DPOAE,multiple frequency steady state(ASSR),brainstem auditory evoked potential.The hearing results are judged by multi frequency steady state with frequency characteristics.Results After DPOAE test,they were divided into the ear group and the non-passing ear group.The positive curved line of not passed group was letter than the pass group(P<0.05).The passed group hearing showed that normal ears was 210(93.8%),mild damage ears was 10(4.5%),moderate damage ears was 2(2.0%),extremely severe damage ears was 2(2.0%).The not passed group hearing showed that normal ears was 82(21.4%),mild damage ears was 60(15.6%),moderate damage ears was 90 (23.4%),severe damage ears was 36(9.4%),extremely severe damage ears was 116(15.6%). The hearing damage of not pass group was severe than the pass group(P<0.05).Conclusion DPOAE hearing screening is a standard for diagnosing normal hearing.The patients passed DPOAE indicated their cochlear,outer and middle ear is normal.DPOAE through the ear 93.8% means normal hearing,DPOAE did not pass 78.6% mean different degree of hearing loss.It is requires a comprehensive hearing test and analysis to make a correct diagnosis.

Objective To analyze the hearing disorders characteristics of children,so as to provide references for clinical treatment.Methods One hundred and fifty cases of abnormal hearing tests with pure tone audiogram,the test with AD229b diagnosis audiometerin the acoustic chamber,judgment standard level of hearing disorders for the WHO and the bone conduction and air conduction hearing threshold,character difference to judge the degree of hearing disorders and nature.Results There were 225 ears with hearing disorders,including 105 ears conductive hearing disorders,93 ears of sensorineural hearing disorders,27 ears of mixed hearing disorders.The main conductive hearing disorders was＜7 years,＞7 years was mixed hearing disorders,of which the age＞7 years of sensorineural hearing disorders was higer than＜7years.There was statistical senses among three groups(P＜0.05).Among 150 patients there were 75 patients were single ear hearing disorders,in which there were 35 ears with conductive hearing disorders,37 ears with sensorineural hearing disorders and 3 ears with mixed hearing disorders.The concentration ratio of sensorineural hearing disorders with single heating disorders was more than conductive hearing disorders(P＜0.05).Conclusion Conductive hearing disorders is mainly mild,moderate,severe and profound deafness.The disorders of sensorineural hearing disorders is more than that of moderate or above hearing disorders,especially in severe and profound deafness cases.single ear sensorineural hearing disorders was severe and e profound deafness.

Objective:To explore the effect of adenoid hypertrophy on children's hearing. Methods:To select 200 cases of children with normal speaking but with adenoid hypertrophy in our department as observation group from January 2016 to January 2017, select another 200 cases of children with nonadenoid hypertrophy were as control group in the same period, compared pure tone hearing test or multiple frequency steady results tested by otoscope and acoustic immittance ear of two groups. Results:According to the WHO classification standard of hearing, the average value of 4 Hz (500, 1000, 2000, 4000 Hz) air conduction threshold less than or equal to 25 dBHl for normal hearing, 26-40 dBHl for mild hearing loss, 41-60 dBHl for moderate hearing loss, and 61-80 dBHl for severe hearing loss, greater than 81 was extremely severe hearing loss. The hearing loss of the two groups was compared, the observation group was higher than the control group, and the difference was statistically significant,P<0. 05. Conclusion:Adenoid hypertrophy can lead to secretory o-titis media, which causes different hearing loss, should be arouse more attention in clinic.

Objective:To analyze the children listening test results and explore the test method and measurement for development disorder of speech,to a-chieve early diagnosis,early intervention. Methods:180 cases with developmental disorder of speech were examined from inquiry of medical history,aural ex-amination,acoustic immittance,otoacousticemission,auditory steady-state response,auditory brainstem evoked potential. Results:Among the180 cases of children,68 cases hearing results were normal,112 cases hearing results were abnormal with 100 cases of severe hearing loss and 12 cases of mild or moder-ate hearing loss. Conclusion: Parents respond to the children sound good,can not speak,most of these children with normal hearing,the hearing on the screening method for these children,for diagnostic tests fail. Prelingual deafness children most severe and very severe deafness. Hearing disorder is the main cause of developmental disorders of speech,but it is not the only reason.

脑性瘫痪（以下简称脑瘫）是自受孕开始至婴儿期非进行性脑损伤和发育缺陷所导致的综合征，主要表现为运动障碍及姿势异常[1]。据报道，约70%～80%脑瘫儿童伴有言语障碍[2]，严重影响其言语交流，因此，脑瘫儿童言语障碍的康复治疗非常重要。我们采用头针结合言语训练疗法治疗脑瘫儿童的言语障碍，取得了较好疗效，现报道如下。

Objective To observe the association between therapeutic effect of speech disorder and the age on treatment of children with cerebral palsy,and to explore the best treatment period of speech disorder children with cerebral palsy.Methods One hundred and twenty-one cases of speech disorder children with cerebral palsy aged 1 to 6 years in Maternal and Child Health Center of Hebei Province,Hebei Children's Hospital,were selected as subjects,and the patients were randomly divided into training group,which included 64 cases who received scalp acupuncture combined with language and 57 cases treated with speech training group.After 6 courses of treatment,the therapeutic effect for speech disorder of children between 1 to 3 years old and ＞ 3 to 6 years old were compared,the association between children's age for treatment and treatment effects was explored.Results The total treatment efficiency of 1 to 3 years and ＞ 3 to 6 years old children in scalp acupuncture group combined with language training group were 95.45％ and 83.33％ respectively,the difference was significant (x2 =6.859 8,P ＜ 0.05) ; while in 1 to 3 years and ＞ 3 to 6 year-old children in speech training group the total treatment efficiency were 84.62％ and 77.42％,and the difference was significant(x2 =6.625 7,P ＜ 0.05).In both groups,total efficiency of 1 to 3 years and ＞ 3 to 6 years old children were 89.58％ and 80.82％,respectively,and the difference was statistically significant (x2 =9.617 5,P ＜ 0.01).Conclusions The best treatment period of speech disorder children with cerebral palsy is less than 3 years old,as age grows,the effect is gradually decreasing.

目的：分析头针结合言语训练对合并认知障碍脑瘫患儿认知障碍疗效的影响。方法：将121例合并言语障碍脑瘫患儿随机分为治疗组64例和对照组57例，经“Gesell诊断发育量表”检测，治疗组中60例合并认知障碍，对照组中53例合并认知障碍。对照组只做基础治疗和言语训练，治疗组加做头针治疗，治疗6个疗程后比较两组中合并认知障碍患儿认知功能的改善效果。结果：治疗组总有效率为93.33％，对照组总有效率为81.13％，两组间的差异有显著性（ P﹤0.05）。结论：头针结合言语训练对脑瘫患儿认知障碍疗效显著、肯定，效果优于单纯言语训练。

OBJECTIVE:To investigate the risk factors for hearing impairment in premature infants.METHODS:A total of 895 premature infants who were admitted to the neonatal intensive care unit from January to December 2010 were evaluated using distortion product otoacoustic emission to detect hearing impairment. The failure rates in initial screening and secondary screening were recorded. The risk factors for failure to pass hearing screenings were elucidate using multivariate logistic regression analysis.RESULTS:The failure rate in initial screening was 38.4%, and the failure rate in secondary screening was 18.3%. In the auditory brainstem response test conducted at three months after birth, the failure rate was 22.2%. In premature infants with a gestational age of 28-29(+6) weeks, 60.5% did not pass the initial screening; 48.1% of the premature infants with a birth weight of 1 001-1 499  g failed the initial screening; 70.0% of the premature infants with a birth weight of ≤1 000  g failed the initial screening; 53.8% of the premature infants who had severe asphyxia failed the initial screening; 45.0% of the premature infants who used invasive ventilation failed the initial screening; 47.9% of the premature infants with a total bilirubin of ≥340 µmol/L failed the initial screening; 54.6% of the premature infants with septicemia failed the initial screenings. The multivariate logistic regression analysis revealed the following independent risk factors for failing the initial and secondary hearing screenings: gestational age, birth weight, hyperbilirubinemia and septicemia.CONCLUSIONS:Premature infants are susceptible to hearing impairment because they have immature organs and tissues and incomplete blood-brain barrier function and are sensitive to such factors as hyperbilirubinemia and infection. Early hearing screening and follow-up are necessary for premature infants to ensure timely interventions.

Objective:To analyze the NICU and the maternity ward for newborn hearing screening results of distortion product otoacoustic emission.Methods:Used distortion product otoacoustic emissions in 1576 cases of NICU and 545 cases of obstetric ward of newborn hearing screening.Results:The pass rate of normal neonatal screening was 85.14%,the pass rate of NICU screening was 56.28%.Conclusion:NICU screening results are affected by many factors,such as disease,test environment,gender etc.In the screening of timely understanding of these factors of distortion product otoacoustic emission,improve the success rate of screening.