新生儿听力筛查11894例结果分析  

Hearing screenings in 11894 infants

作　　者：刘志奇[1,2] 刘立思[1] 杨琨[3] 

机构地区：[1]华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科,武汉430030 [2]湖北省妇幼保健院耳鼻咽喉科,武汉430070 [3]武汉大学人民医院耳鼻咽喉头颈外科,武汉430060

出　　处：《山东大学耳鼻喉眼学报》2013年第2期8-12,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的了解新生儿听力筛查的通过率、听力损失的发病率,分析可能导致新生儿听力损失的原因。方法瞬态诱发性耳声发射(TEOAE)按两阶段方案进行听力筛查,11 894例新生儿中未通过者3月龄后行畸变产物耳声发射(DPOAE)、1 000 Hz探测音鼓室导抗、听性脑干反应(ABR)测试,结果用统计学软件SPSS15.0分析。结果初筛通过率为82.64%,复筛通过率为78.71%。产科病区新生儿初筛通过率为84.63%,新生儿重症监护病房(NICU)新生儿初筛通过率为78.00%,经比较两者差异有统计学意义(ANOVA,P<0.05)。确诊有听力损失患者68例(106耳),发病率约为0.57%,其中传导性听力损失31例,感音神经性听力损失16例,混合性听力下降21例。听力筛查双耳未通过组和单耳未通过组听力损失的患病率分别为12.92%(38/294)、5.00%(30/600),中度及中度以上听力损失的比例分别为3.33%(1/30)、18.42%(14/76),经比较差异有统计学意义(ANOVA,P<0.05)。引起听力损失的可能原因有:黄疸(24.56%,14/57),感染(24.56%,14/57),窒息(19.30%,11/57),低体质量(17.54%,10/57),其他因素(14.04%,8/57)。结论听力筛查是早期发现新生儿听力损失的基础性工程;双耳听力筛查未通过比单耳听力筛查未通过患儿存在听力损失的可能性更大,听力损失的程度也可能更重;黄疸、感染、窒息和新生儿低体质量是导致听力损失的常见原因。Objective To obtain the pass rate of hearing screening, the incidence and cause of heating loss in the new- borns. Methods 11 894 cases were screened by a two-stage program of transient evoked oto-acoustic emissions test （TEOAE）. The failed were re-examined with DPOAE, 1 000 Hz probe tone tympanometry, auditory brainstem response （ABR） 3 months later. The results were analyzed. Results The primary screening pass rate was 82.64%, while the secondary pass rate was 78.71%. The pass rates were 84.63% and 78.00% in the obstetric ward and NICU ward,re- spectively （ANOVA, P 〈 0.05 ）. 68 cases （including 106 ears） were diagnosed as hearing loss with the incidence rate at 0.57%. Among them, there were 31 conductive hearing loss, 16 sensorineural hearing loss, and 21 mixed hearing loss. In the groups with the tests failed bilaterally or unilaterally , the corresponding prevalence rate was 12.92% （38/294） or 5.00% （30/600）. The proportions of moderate and severe hearing were 3.33% （1/30） and 18.42% （14/76） （ ANOVA, P 〈 0.05 ）. The possible causes of hearing loss consisted of jaundice （ 24.56% , 14/57 ） , infec- tion （24. 56%, 14/57）, asphyxia （19. 30%, 11/57）, low birth weight （17. 54%, 10/57）, and other factors （ 14.04%, 8/57）. Conclusion Hearing screening is a basic project for early detection of neonatal heating loss. Bin- aurally failed cases are more likely to develop into hearing loss than the unilateral, and the degree of hearing loss might also be more severe. Jaundice, infection, asphyxia, and low birth weight are major causes for neonatal heating loss.

关 键 词：听力筛查 耳声发射 听性脑干反应 鼓室导抗测试 体层摄影术 X线计算机 新生儿 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]