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摘要: 目的 探讨先天性耳廓形态畸形的发病特点、高危因素及不同类型形态畸形之间高危因素的差异，为耳廓形态畸形的精准防控提供理论依据。 方法 对2022年5月-2023年1月于郑州大学第二附属医院足月出生的新生儿行耳廓畸形筛查，收集信息资料，自制问卷进行高危因素调查，采用病例对照研究方法，以耳廓形态畸形的新生儿为病例组，选取同期无耳廓形态畸形的新生儿作为对照组，分析耳廓形态畸形的发生率、高危因素及不同类型耳廓形态畸形高危因素的差异。 结果 本研究共纳入1 758例新生儿(3 516耳)，耳廓形态畸形新生儿562例，共927耳，先天性耳廓形态畸形的发生率为26.37%。其中耳轮畸形289耳(8.22%)、垂耳244耳(6.94%)、混合畸形166耳(4.72%)、招风耳/杯状耳131耳(3.73%)、Stahl's耳79耳(2.25%)、耳甲腔异常凸起16耳(0.46%)、隐耳2耳(0.06%)。母亲孕早期感染史(OR=1.513，95%CI 1.119~2.045)、既往流产史(OR=1.300，95%CI 1.049~1.613)、异常妊娠(OR=1.278，95%CI 1.032~1.582)是先天性耳廓形态畸形的危险因素。耳轮畸形、垂耳和混合畸形在母亲孕早期感染史(χ2=1.877，P=0.391)、既往流产史(χ2=4.706，P=0.095)、异常妊娠(χ2=5.026，P=0.081)差异无统计学意义。 结论 先天性耳廓形态畸形发生率高，以耳轮畸形、垂耳、混合畸形较为常见，耳廓形态畸形由多种因素导致，同一危险因素对不同类型形态畸形的影响大致相同。Abstract: Objective To Explore the clinical characteristics, risk factors, and differences in risk factors for different types of congenital auricular deformities, in order to provide theoretical basis for precise prevention and control of congenital auriclar deformity. Methods Full-term newborns born in the Second Affiliated Hospital of Zhengzhou University from May 2022 to January 2023 were screened for auricle malformation, general information and data were collected, , and high-risk factors were investigated withself-made questionnaire.Using a case-control study method, newborns with auriclar deformities were selected as the case group and those without auriclar deformities during the same period were selected as the control group.A case-control study was conducted to analyze the incidence rate, high-risk factors, and differences in high-risk factors for different types of auricle deformities. Results A total of 1 758 newborns (3 516 ears) were included in this study, including 562 newborns(927 ears) with auriclar deformities, the incidence of congenital malformations of the auricle is 26.37%.Among them, 289 ears (8.22%) were helical rim deformity, 244 ears (6.94%) were lidding/lop ear, 166 ears (4.72%) were mixed deformities, 131 ears (3.73%) were prominent/cup ear, 79 ears (2.25%) were Stahl's ears, 16 ears (0.46%) were abnormal conchal crus, and 2 ears (0.06%) were cryptotia.Maternal history of infection in early pregnancy(OR=1.513, 95%CI 1.119-2.045), previous miscarriage history(OR=1.300, 95%CI 1.049-1.613), and abnormal pregnancy(OR=1.278, 95%CI 1.032-1.582) are risk factors for congenital auricular malformations.There was no statistically significant difference in the history of infection(χ2=1.877, P=0.391), previous miscarriage(χ2=4.706, P=0.095), and abnormal pregnancy(χ2=5.026, P=0.081) among mothers with helical rim deformity, lidding/lop ear, and mixed deformities. Conclusion The incidence rate of congenital auricle deformity is high, with common malformations such as helical rim deformity, lidding/lop ear, and mixed deformities. Congenital auricular deformity is caused by various factors, the same risk factor has roughly the same impact on different types of morphological abnormalities.
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Key words:
- congenital auriclar deformity /
- incidence /
- risk factors
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表 1 新生儿耳廓形态畸形的单因素分析
例 危险因素 对照组(n=1 196) 病例组(n=562) χ2 P 危险因素 对照组(n=1 196) 病例组(n=562) χ2 P 性别 2.206 0 0.138 母亲孕前BMI 3.647 0 0.302 男 782 347 ＜18.5 88 47 女 414 215 18.5~23.0 795 377 分娩方式 2.468 0 0.116 24.0~27.0 268 126 顺产 481 204 ≥28.0 45 12 剖宫产 715 358 保胎药物服用史 1.084 0 0.298 出生体重 1.734 0 0.420 无 583 259 ＜2 500 g 58 25 有 613 303 2 500~4 000 g 1 041 481 既往流产史 12.199 0 ＜0.001 ≥4 000 g 97 56 无 770 313 母亲肝炎病史 4.558 0 0.033 有 426 249 无 1 130 516 异常妊娠 8.345 0 0.004 有 66 46 无 599 240 孕早期感染史 7.389 0 0.007 有 597 322 无 1 072 479 父亲吸烟史 1.625 0 0.202 有 123 83 无 778 348 有 418 214 
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表 2 新生儿耳廓形态畸形的多因素分析
危险因素 回归系数 标准误差 Wald χ2 P OR 95%CI 上限 下限 肝炎病史 0.374 0.201 3.471 0.062 1.453 0.981 2.153 孕早期感染史 0.414 0.154 7.232 0.007 1.513 1.119 2.045 既往流产史 0.263 0.110 5.721 0.017 1.300 1.049 1.613 异常妊娠 0.245 0.109 5.061 0.024 1.278 1.032 1.582
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表 3 不同类型耳廓形态畸形间的危险因素分析
例 形态畸形 孕早期感染史 既往流产史 异常妊娠 类型 无 有 无 有 无 有 耳轮畸形 258 31 202 87 163 126 垂耳 224 20 173 71 158 86 混合畸形 154 12 131 35 92 74 χ2 1.877 4.706 5.026 P 0.391 0.095 0.081
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