足月新生儿宽频声导抗能量吸收率初步研究  

A Preliminary Study of the Wideband Absorbance in Full-term Neonates

作　　者：郝文洋 商莹莹[1] 倪道凤[1] 高志强[1] 徐春晓[1] 李奉蓉[1] 赵翠霞[1] 王素菊[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京100730

出　　处：《中国听力语言康复科学杂志》2015年第5期329-333,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：公益性卫生行业科研专项项目（201202005）;国家科技部“十二五”支撑项目（2012BA112800）;国家临床重点专科基金

摘　　要：目的测量普通产科病房足月新生儿宽频声导抗能量吸收率（wideband absorbance，WBA），对比瞬态诱发耳声发射（TEOAE）初筛通过者与未通过者WBA的差异，探讨宽频声导抗（wideband acoustic immittance，WAI）测试在评估新生儿中耳功能中的作用。方法使用Titan听力测试平台，对2014年7～9月在北京协和医院出生并入住普通产科病房且年龄为48～72d,时的足月新生儿进行WAINU试，选取TEOAE初筛通过者124例（193耳）和未通过初筛但通过复筛者41例（55耳），分析不同频率WBA的变化规律及TEOAE初筛通过者与未通过者WBA的差异。结果TEOAE初筛通过组与未通过组WBA均随频率增大呈“两峰两谷”的形态，即在低频（408～840Hz）及3363Hz附近较低，在1296Hz附近及高频（5339～6727Hz）较高。TEOAE初筛通过组在全频范围内WBA均比未通过组高。当外耳道压力处于0 daPa时，2000、4000～6727Hz三个频率TEOAE初筛通过组与未通过组WBA差异具有统计学意义（P〈0．05）；当外耳道处于峰压时，各频率TEOAE初筛通过组与未通过组WBA差异均无统计学意义（P〉0．05）。关于TEOAE初筛通过组与未通过组WBA的差值，除226Hz外的其它频率，当外耳道处于0daPa时比处于峰压时大。结论足月新生儿各频率WBA总体趋势一致，但TEOAE初筛通过组在全频范围内WBA均比未通过组高。当外耳道处于0daPa压力时比处于峰压时TEOAE初筛通过组与未通过组WBA差异更明显，其对评估新生儿中耳功能有一定意义。Objective To test and compare the wideband absorbance （WBA） of full-term neonates who passed and failed the transient evoked otoacoustic emission （TEOAE） test in the first hearing screening and to explore the effect of wideband acoustic immittance （WAI） test in the assessment of middle ear function in neonates. Methods A total of 165 full-term neonates born in Peking Union Medical College Hospital from July to September in 2014 were enrolled in this study 48 to 72 hours after birth. 124 neonates （193 ears） passed TEOAE screening test and 41 neonates （55 ears） failed the first screening but passed TEOAE at the second-step screening at the age of one to two months. WAI tests were performed and their characteristics under different frequencies were analyzed when the external ear canals were at 0 daPa and tympanometric peak pressure. The differences between those who passed and failed TEOAE were also compared. Results The values of WBA were lower at low frequencies （408-840 Hz） and frequencies around 3363 Hz, while higher at frequencies around 1296 Hz and high frequencies （5339~6727 Hz）. WBA of passed group were higher than the failed group at all frequencies. The differences were statistically significant （P〈 0.05） for the frequencies of 2000, 4000 and 6727 Hz when the external ear canal was at 0 daPa, while the differences were not statistically significant （P 〉 0.05） for all frequencies at tympanometric peak pressure. In addition, the differences between TEOAE pass and refer group were greater at 0 daPa than tympanometric peak pressure for all frequencies except 226 Hz. Conclusion The characteristics of WBA under different frequencies are similar for all full-term neonates. WBA of the passed group was higher than that of the failed group at all frequencies, and the differences were greater at 0 daPa than at tympanometric peak pressure. WAI test may provide useful information for the assessment of neonate middle ear function.

关 键 词：新生儿 宽频声导抗 宽频声导抗能量吸收率 

分 类 号：R722.12[医药卫生—儿科]