听力复筛不通过的转诊婴儿听力学评估  

Audiological evaluation of infants referred for failed secondary hearing screening

作　　者：王靖明[1] 李洁[1] 秦英 陈延龄 徐学海[3] 陈丕亮[1] 

机构地区：[1]甘肃省妇幼保健院新生儿疾病筛查中心,甘肃兰州730050 [2]临夏州人民医院,甘肃临夏731100 [3]兰州军区兰州总医院,甘肃兰州730050

出　　处：《中国耳鼻咽喉颅底外科杂志》2018年第1期29-32,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：甘肃省卫生行业科研计划管理项目(GWGL 2014-90)

摘　　要：目的评估两次听力筛查未通过转诊婴儿的临床听力学。方法对210耳两次听力筛查未通过转诊的婴儿进行听性脑干反应(ABR)、听性稳态反应(ASSR)、40Hz听觉相关电位(40 Hz-AERP)、畸变产物耳声发射(DPOAE)、声导抗(AI)等检查,并分析其结果。结果两次未通过听力筛查的210耳中,有听力损失143耳,听力损失的检出率为68.10%(143/210)。其中传导性听力损失62耳,占听力损失耳43.36%(62/143);感音神经性听力损失81耳,占听力损失耳56.64%(81/143)。确诊大前庭导水管扩大综合征(LVAS)16耳,发病率为7.62%(16/210)。诊断为类听神经病6耳,发病率为2.85%(6/210)。结论两次听力筛查未通过的听力损失检出率较高,对于听力高危因素婴幼儿的听力动态随访有待更加关注,应结合婴儿生理特点更加精准的进行听力学诊断,及其本身的生理发育特点全面评估。Objective To evaluate the audiological results of referral infants for failed secondary hearing screening. Methods The audiological results of 210 ears were analyzed. All the referral infants received audiological evaluationin cluding auditory brainstem response （ABR）, auditory steady-state response （ASSR）, distortion product otoacoustic emission（ DPOAE）, 40 Hz auditory event-related potentials and acoustic impedance. Results Of all the 210 ears, 143 were confirmed to have hearing loss with adetection rate of 68. 10% （143/210）. Of the confirmed 143 ears, 62 ears （43.36%） were conductive and 81 ears （56.64%） were sensorineural. Large vestibular aqueduct syndrome （LVAS） was diagnosed in 16 ears with an incidence of 7.62% （16/210）. Auditory neuropathy spectrum disorder was confirmed in 6 ears with an incidence of 2.85% （6/210）. Conclusions The detection rate of hearing loss is high in infants who have failed secondary hearing screening. We should pay more attention to carry out dynamic follow-up for hearing in infants with high risk factors. Accurate and comprehensive audiological evaluations should be conducted combined with the physiological characteristics of infants.

关 键 词：听力筛查 转诊 听力损失 婴幼儿 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]