AABR和DPOAE联合筛查在NICU新生儿听力筛查中的应用  

The Combined Application of Automated Auditory Brainstem Responses and Distortion Product Otoacoustic Emissions to the NICU Newborn Hearing Screening

作　　者：刘海红[1] 张亚梅[1] 王秋菊[2] 周怡[1] 倪鑫[1] 

机构地区：[1]首都医科大学附属北京儿童医院耳鼻咽喉头颈外科儿童耳鼻咽喉头颈疾病北京市重点实验室,北京100056 [2]解放军总医院耳鼻咽喉头颈外科解放军耳鼻咽喉研究所耳内科及临床听力医学中心,北京100086

出　　处：《中国听力语言康复科学杂志》2015年第5期324-328,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：国家自然科学基金（81300838）;北京市自然科学基金（7144212）;北京市科技新星计划（XX2014B059）

摘　　要：目的运用自动听性脑干反应（AABR）和畸变产物耳声发射（DPOAE）技术在NICU新生儿中开展听力筛查，获得NICU新生儿听力筛查阳性率，并探索NICU新生儿听力筛查阳性率的影响因素。方法筛查对象为2010年7月～2015年5月首都医科大学附属北京儿童医院NICU收治的2353例新生儿，全部采用AABR和DPOAE进行新生儿听力筛查并计算阳性率。同时采集新生儿及其母亲孕期相关因素，分析资料完整的2095例NICU新生儿听力筛查阳性率及其潜在影响因素。结果AABR左耳和右耳筛查阳性率分别为28．59％和26．73％，DPOAE左耳和右耳筛查阳性率分别为26．01％和22．63％，分析显示左右耳（x^2=0．706，P=0．401）和两种不同筛查技术（x^2=1．540，P=0．215）间阳性率均无显著差异。不同性别的新生儿筛查阳性率无显著性差异（x^2=2．89，P=0．089）。x^2检验显示伴有感染、高胆红素血症、窒息、低体重、早产、发育迟缓和多胞胎因素的NICU新生儿听力筛查阳性率显著高于不伴有上述因素的新生儿。结论感染、窒息、高胆素血症可能为NICU新生儿听力筛查呈阳性的危险因素。Objective To perform hearing screening in NICU newborns with automated auditory brainstem response（ABR） and distortion product otoacoustic emission（DPOAE）,to obtain the positive rates of hearing screening in NICU newborns and to explore related influential factors. Methods A total of 2353 NICU newborns in Beijing Children＇s Hospital,Capital Medical University received the hearing screening with AABR and DPOAE. The clinical data of the newborns and their mothers were collected. The positve rates of hearing screening were calculated for 2095 newborns with complete data and the influential factors of positive rates were analyzed. Results The AABR positive rates of the left and right ear were 28.59% and 26.73%, respetively. The DPOAE positive rates of the left and right ear were 26.01% and 22.63%,respectively. There were no significant difference in the positive rate between left and right ear as well as the two screening techniques. No significant difference was noted in the positve rate between males and females（X2=2.89,P=0.089）. Chi-square test showed that the positive rates of NICU newborns with infection, hyperbilirubinemia, neonatal intrauterine fetal distress, low birth weight, premature delivery, developmental retardation and twins were significantly higher than those without these factors. Conclusion Infection, neonatal intrauterine fetal distress and hyperbilirubinemia may increase the risk of positive result in hearing screening for NICU newborns.

关 键 词：听力筛查 新生儿重症监护室 自动听性脑干反应 畸变产物耳声发射 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]