新生儿重症监护病房中高危新生儿听力筛查研究  

Newborn hearing screening in neonatal intensive care unit

作　　者：祁伯祥[1] 林小娟[2] 柳炯[3] 杨于嘉[1] 赵素萍[3] 

机构地区：[1]中南大学湘雅医院新生儿科,湖南长沙410008 [2]湖南省人民医院新生儿科,湖南长沙410000 [3]中南大学湘雅医院耳鼻咽喉科,湖南长沙410008

出　　处：《中国耳鼻咽喉颅底外科杂志》2005年第4期232-235,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：湖南省计生委资助项目(项目批准号2002-25)。

摘　　要：目的探讨新生儿重症监护病房(NICU)中高危新生儿采用听力筛查模式和听力障碍发病情况与危险因素。方法采用畸变产物耳声发射(DPOAE)对NICU中高危新生儿病情稳定时进行初筛,未通过者4～6周后作第二次复查,仍未通过者分别于4～6月龄和1岁时进行听觉脑干诱发电位(ABR)检查,两次ABR均未通过者确诊为真性听力损失。结果随机筛查63例高危儿,初检结果阳性22例,阳性率为34.9%,其中有关脑损伤危险因素的阳性率高达71.4%。复检22例,复检率100%,复检阳性5例,通过率为77.3%。4～6月龄和1岁时作ABR检查,确诊有听力障碍2例,其中1例为葡萄糖6磷酸脱氢酶(G6PD)缺乏发生核黄胆,另1例为迟发性维生素K缺乏症引起颅内出血。63例高危新生儿中听力障碍发病率为3.2%。其听力障碍原因均与脑损伤有关。结论NICU中高危新生儿是听力障碍的高发人群,应该常规进行听力筛查,中枢神经系统受损是导致听力障碍的高危因素,DPOAE结合ABR是一种较好的高危新生儿听力筛查方法。Objective To investigate the model of hearing screening, the incidence of hearing impairment and the rdevant pathogenic factors among the high-risk newborns in the neonatal intensive care unit （NICU）. Methods Random samples of 63 newborns in stable condition received hearing screening test initially with distortion prcx：luct otoacoustic emission （DPOAE）. All the babies who didn＇t pass the test would receive screening again after 4-6 weeks. The infants who failed to pass both tests would receive auditory brain stem response （ABR） test at 4-6 months and one year old respectively. Two positive results of ABR test suggested hearing impairment. All data were analysed by SPSS 10.0. Results Twenty-two （34.9%） infants didn＇t pass the initially DPOAE test among the 63 infants. The positive rate correlated with brain damage was 71.4%. All abnormal infants （100%） took part in the second screening test. Five （7.9%） infants got positive results. Two （3.2%） infants, who respectively suffered from Glucose-6-Phosphate- Dehydrogenase （G-6PD） deficiency, and deficiency of vitamine K resulted in kernicterus and intracranial hemorrhage, failed to pass ABR test and were confirmed having a hearing disorder caused by brain damage. Conclusion The incidence of hearing loss among high-risk newborns in NICU is high and these newborns should receive hearing screening routinely. The damage of central nervous system （CNS） is a high risk factor responsible for hearing disorder. DPOAE combined with ABR is a preferable way for hearing screening among high-risk newborns.

关 键 词：新生儿重症监护病房 听力筛查 听力障碍 危险因素 脑损伤/诊断 

分 类 号：R651.75[医药卫生—外科学] R764.04[医药卫生—临床医学]