1021例新生儿听力初筛结果与听力损失危险因素的相关性分析  

Correlation between risk factors of hearing lose and results of initial hearing screening in 1021 neonates

作　　者：孙鹏程[1] 梁勇[1] 谭曼玲[1] 袁艺昕 杨衬[1] 刘友利[1] 刘小龙[1] 张威[1] 李琦[1] 

机构地区：[1]南方医科大学南方医院耳鼻咽喉头颈外科,广州510515

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第10期893-898,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：通过对1 021例可能具有听力损失危险因素的新生儿行畸变产物耳声发射（DPOAE）结果分析,探讨新生儿听力初筛未通过的危险因素。方法：回顾2009-06-2012-01期间于我院产科出生,因各种原因入住我院新生儿科,并于住院期间完成听力初筛的1 021例资料完整新生儿病例资料,记录母儿孕产期因素及DPOAE。并对未通过病例进行电话随访;采用单因素χ2检验和多因素Logistic回归分析,筛选出影响DPOAE听力初筛的独立危险因素。结果：11 021例（2 042耳）新生儿,听力初筛未通过137例（13.42%）,其中双耳未通过51例（5.00%）,单独左耳未通过47例（4.60%）,单独右耳未通过39例（3.82%）。2单因素分析显示出生体重、小于胎龄儿、胎数、孕周、分娩方式、羊水过少、催产素、新生儿出生血糖、Apgar评分（1min）、孕产期使用糖皮质激素、新生儿颌面部畸形、新生儿缺血缺氧性脑病、新生儿呼吸窘迫综合征、新生儿出生后窒息等14个因素对DPOAE听力初筛的影响差异有统计学意义（P〈0.01）。3出生体重〈1 500g、多胎妊娠、Apgar评分（1min）〈5分、孕产期使用糖皮质激素以及新生儿颌面部畸形等5个影响DPOAE听力初筛的独立危险因素差异有统计学意义（OR=3.132、1.808、2.615、1.827、12.174;95%CI分别为1.466~6.691、1.120~2.917、1.317~5.336、1.130~2.953、1.986~74.632）。4电话随访的结果提示Apgar评分（1min）〈5分是言语发育的危险因素。结论：具有潜在高危因素的新生儿中,出生体重〈1 500g、多胎妊娠、Apgar评分（1 min）〈5分、孕产期使用糖皮质激素以及新生儿颌面部畸形是不能通过DPOAE听力初筛的危险因素,应对合并上述危险因素的新生儿加强听力监测。Objective.. To explore the risk factors of the newborns who failed initial bearing screening by analy- sing the distortion production otoacoustic emission （DPOAE） results of 1 021 newborns with potential risk factors of hearing loss. Method.. All newborns, who were born in obstetrical department and admitted in the neonatal de- partment of the Nanfang Hospital during June 2009 to January 2012 and underwent initial hearing screening, were included in this study. Their clinical data and DPOAE results were analyzed retrospectively in order to identify the risk factors for failure of initial hearing screening in infants; cases who failed the DPOAE test were followed up by telephone interviews. Result：①One hundred and thirty-seven cases （13.42 %） of the 1 021 newborns did not pass the hearing screening. 51 cases （5.00%） did not pass the test in both ears. Meanwhile, left ear in 47 cases （4.60 % ） and right ear in another 39 cases （3.82 %） failed the test respectively.②Univariate analysis showed that 14 factors had significant influence on the hearing screening results, such as birth weight, small for gestational age, multiple pregnancy, gestational age, delivery mode, oligohydramnion, oxytocin, blood sugar level of new- born, Apgar scores at 1 min, exposed prenatally to glueocorticoid, maxillofacial deformity, hypoxic-ischemic en- cephalopathy, neonatal respiratory distress syndrome and neonatal asphyxia （P〈0.01）. ③ Multivariate Logistic regression analysis suggested that birthweight less than 1 500 g, multiple pregnancy, Apgar scores of 0--4 at 1 min, exposed prenatally to glucocorticoid and maxillofacial deformity were risk factors for failure of initial hearing screening （OR were 3. 132, 1. 808, 2. 615, 1. 827 and 12. 174 respectively; 95%CI were 1. 466-6. 691, 1. 120- 2. 917, 1. 317-5. 336, 1. 130-2. 953 and 1. 986-74. 632 respectively）. ④Results of telephone interviews re- vealed that Apgar scores of 0-4 at 1 min would be a risk factor of language development. Conclusion：

关 键 词：新生儿 听力筛查 畸变产物耳声发射 危险因素 

分 类 号：R764[医药卫生—耳鼻咽喉科]