甘肃省河西走廊19323例新生儿听力筛查结果分析  

19323 Cases of Neonatal Hearing Screening in Gansu Corridor

作　　者：丁文娟[1] 郭玉芬[1,2] 张哲文[1] 刘晓雯[1] 徐百成[1] 程世红[1] 兰兰[3] 韩冰[3] 王秋菊[3] 

机构地区：[1]兰州大学第二医院耳鼻咽喉头颈外科,兰州730030 [2]甘肃省卫生厅 [3]解放军总医院耳鼻咽喉头颈外科解放军耳鼻咽喉研究所

出　　处：《听力学及言语疾病杂志》2012年第4期305-308,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然基金面上项目(30771857);国家自然基金重点项目(30830104);国家"十一五"科技支撑计划(2007BAI18B12);甘肃省科技厅-技术研究与开发专项计划(0805TCYA004);甘肃省自然科学研究基金计划(096RJZA074);北京市自然科学基金重大项目(7070002)联合资助

摘　　要：目的了解甘肃省河西走廊先天性听力损失发病情况,并探寻适合偏远、经济欠发达、多民族聚集地区新生儿听力普遍筛查的模式。方法采用畸变产物耳声发射(DPOAE)对2009年7月～2010年9月出生于甘肃省河西走廊地区的19 323例新生儿及婴儿在其出生后两月龄内实施普遍听力筛查,初筛未通过者间隔一月进行DPOAE复筛,复筛未通过者在3月龄(第一次诊断)和6月龄时(第一次诊断听力异常者,进行第二次诊断)进行DPOAE、ABR、声导抗等听力学检查及跟踪随访。结果接受听力筛查的19 323例新生儿及婴儿中,初筛通过16 843例(87.17%),未通过2 480例(12.83%)。18 417例正常儿中初筛通过16 078例(87.30%),未通过2 339例(12.70%);906例高危儿中初筛通过765例(84.44%),未通过141例(15.56%)。初筛未通过需进行复筛2 480例,实际复筛916例,复筛率36.94%,复筛通过853例(93.12%),未通过63例(6.88%)。接受复筛的875例正常儿中复筛通过824例(94.17%),未通过51例(5.83%)。接受复筛的41例高危儿中复筛通过29例(70.73%),未通过12例(29.27%)。初筛复筛未通过由当地筛查机构转诊接受进一步听力学诊断检查的受试儿应有63例,实际进行诊断的仅19例,11例最终确诊为听力损失的患儿中8例为传导性听力损失(6例单耳,1例双耳,1例右耳先天性外耳道闭锁),3例为感音神经性听力损失(1例双耳、1例单耳极重度听力损失,1例前庭水管扩大)。结论应用畸变产物耳声发射对农村及城乡结合地区广泛开展新生儿听力筛查是可行的,但目标人群复筛率、转诊率低,漏筛率、失访率高仍是亟待解决的问题。Objective To investigate the prevalence of congenital hearing impairment among newborns in the Gansu corridor and to explore feasible neonatal hearing screening protocol in remote and undeveloped area. Methods Nineteen thousand three hundred and twenty--three infants born in Gansu corridor from July 2009 to Sep 2010 re- ceived initial hearing screening using distortion product otoaeoustic emission （DPOAE） before two months. The in- fants who failed initial screening were checked again one month later using DPOAE. Follow--up and relevant as- sessments of the hearing were provided continually for those who failed both tests. Results Out of 19 323 infants, 16 843（87.17%） passed and 2 480 （12.83%） failed. Among 18 417 normal newborns, 16 078 （87.30%） passed and 2 339 （12.83%） failed. Among 906 newborns with high--risk, 765 （84.44%） passed and 141 （15.56%） failed. 2 480 newborns needed screening again, however only 916 （36.94%） accepted rescreening on time, of whom 853 （93.12%） passed and 63 （6.88%） failed. Among 875 normal newborns receiving rescreening, 824（94.17%） pas- sed, 51（5. 83%） failed. Among 41 newborns with high--risk receiving rescreening, 29 （70. 730/oo） passed, 12 （29.27%）failed. 63 infants failed the first screening and rescreening, but only 19 of them received diagnostic assessment, of whom 11 were diagnosed as hearing loss infants（8 conductive hearing loss and 3 sensorineural hearing loss）. Oonclusion It＇s feasible to conduct hearing screening program in the rural areas. However ,the suitable mod- el to perform the program is urgently needed to be set up in order to improve the accuracy and widen the scope of screening.

关 键 词：新生儿 听力筛查 河西走廊 畸变产物耳声发射 听力损失 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]