144例听力筛查未通过婴幼儿听力损失高危因素分析  

Analysis of high risk factors for hearing loss in 144 neonateswho failed in the hearing screening

作　　者：朱伟[1] 杨克林[1] 余崇仙[1] 吴开乐[1] 童步升[1] 段茂利[1,2] 

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉-头颈外科,合肥230022 [2]瑞典皇家医科大学耳鼻咽喉-头颈外科听力与交流中心,斯德哥尔摩17176

出　　处：《安徽医科大学学报》2011年第6期576-579,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的分析144例两次未通过听力筛查的婴幼儿听性脑干反应(ABR)基本特征,探讨其存在的导致听力障碍的高危因素。方法收集两次听力筛查均未通过的患儿,共144例(288耳),于我院行ABR测试,以了解婴幼儿听力障碍的情况,对听力障碍结果进行评估和确认,并通过非条件Logistic回归模型分析听力障碍高危因素。结果 144例中有93例(64.58%)最后经ABR确诊有听力损失,其中轻度44例(30.56%),中度26例(18.06%),重度6例(4.17%),极重度17例(11.81%)。经Logistic回归分析得出:母亲羊水异常、胎膜早破为婴幼儿轻中度听力障碍的高危因素;胎儿窘迫为婴幼儿重度和极重度听力障碍的高危因素。结论母亲羊水异常、胎膜早破、胎儿窘迫为婴幼儿听力损失的高危因素,应早期发现并得到相应的干预,减少对婴幼儿听力产生的负面影响。Objective To analyze the auditory brainstem response（ABR） characteristics in neonates who failed in the first and second hearing screening and explore the high-risk factors of hearing loss. Methods 144 infants（288 ears） failed in the first and second screening with detailed and complete birth-records and hearing screening records in the study. After they were taken to our hospital,ABR were examined to evaluate and certificate the screening results. Meanwhile, high risk factors were analyzed by unconditioned Logistic regression analysis. Results Among the 144 cases,93 cases （64.58%） were diagnosed of hearing loss, with 44 cases （30.56%） of mild hearing loss,26 cases （ 18.06% ） of moderate hearing loss, 6 cases （4. 17% ） of severe hearing loss, 17 cases （ 11.81% ） of profound hearing loss. The risk factors for mild-to-moderate hearing loss were amniotic fluid disorder, premature rupture of fetal memebrane. The risk factor for severe-to-profound hearing loss was fetal distress. Conclusion The high-risk factors for hearing loss are amniotic fluid disorder, premature rupture of fetal membrane and fetal distress. Early detecting and early intervening are dispensable to reduce negative effect to infants.

关 键 词：听力障碍/诊断 新生儿筛查 听力检查 耳声发射 自发性 危险因素 

分 类 号：R764.4[医药卫生—耳鼻咽喉科] R338.3[医药卫生—临床医学]