3~6岁儿童不同听力筛查方法比较  

A Comparative Analysis of 3 Hearing Screening Methods for Children Aged 3 to 6 Years

作　　者：崔庆佳[1] 黄丽辉 韩任杰 闫瑾[1] 刘芳 王蕊[1] 张雷 杨帆 楼颖[1] 恩晖 程晓华 赵雪雷 文铖 任霞 Cui Qingjia;Huang Lihui;Han Renjie;Yan Jin;Liu Fang;Wang Rui;Zhang Lei;Yang Fan;Lou Ying;En Hui;Cheng Xiaohua;Zhao Xuelei;Wen Cheng;Ren Xia(Department of Otolaryngology,Beijing Rehabilitation Hospital,Capital Medical University,Beijing,100144,China)

机构地区：[1]首都医科大学附属北京康复医院耳鼻喉科,北京100144 [2]首都医科大学附属北京同仁医院北京市耳鼻咽喉科研究所耳鼻咽喉头颈外科学教育部重点实验室 [3]首都医科大学 [4]北京市石景山区妇幼保健院

出　　处：《听力学及言语疾病杂志》2020年第2期128-132,共5页Journal of Audiology and Speech Pathology

基　　金：国家重点研发计划项目(2018YFC1002200);北京市自然科学基金面上项目(7172052);中国康复医疗机构联盟基金资助青年项目(20160301)。

摘　　要：目的探讨适合3~6岁年龄段儿童的听力筛查方法。方法对590例3~6岁儿童进行听力筛查,筛查方法包括:家长调查问卷(由其监护人填写)、筛查型畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)和便携式听觉评估仪筛查,任意一项筛查未通过者转诊进行听力诊断;同时按年龄将其分为3~岁组(157例)、4~岁组(235例)和5~6岁组(198例),比较三种方法在三个年龄组间的配合度和通过率。结果①590例中,三种方法的配合度由高到低依次为筛查型DPOAE(100%)、家长调查问卷(98.14%)、便携式听觉评估仪筛查(73.05%),两两间差异有统计学意义(P<0.001);家长调查问卷、筛查型DPOAE在三个年龄组间配合度的差异均无统计学意义(P>0.05);便携式听觉评估仪筛查在3~岁组、4~岁组、5~6岁组的配合度分别为28.03%、81.70%和98.48%,随着年龄增加,便携式听觉评估仪筛查的配合度增加,且差异有统计学意义(P<0.001)。②家长调查问卷、筛查型DPOAE和便携式听觉评估仪三种方法的听力筛查通过率分别为100%、86.10%和97.22%,差异有统计学意义(P<0.001)。③任意一项筛查未通过者88例(其中筛查型DPOAE82例,便携式听觉评估仪筛查11例),接受听力诊断53例,最终确诊听力异常17例,其中单侧轻-中度感音神经性听力损失1例(1.69‰,1/590),分泌性中耳炎16例(2.71%,16/590)。结论3~4岁儿童适宜用筛查型DPOAE进行听力筛查,5~6岁儿童可采用筛查型DPOAE和/或便携式听觉评估仪进行听力筛查,家长调查问卷的配合度虽好,但假阴性率过高,不适用于3~6岁儿童听力筛查。Objective To study the appropriate method of hearing screening for children aged 3 to 6 years.Methods A total of 590 children aged 3~6 years were included for hearing screening.The methods included questionnaires,screening distortion product otoacoustic emission(DPOAE),and portable audiometer.Children were divided into three groups:3~years old,4~years old and 5~6 years old.This study was a contrastive analysis of the compliance and the pass rate with the three methods in different groups.Results①The compliance for questionnaires,screening distortion otoacoustic emission and portable audiometer accounted for 98.15%,100%and 73.05%,respectively(P<0.001).Questionnaires,and screening DPOAE in 3 groups were not significantly different(P=0.1).The portable audiometer in 3 groups accounted for 28.03%,81.70%and 98.48%,respectively(P<0.001).②The pass rate of questionnaires,screening DPOAE and portable audiometer accounted for 100%,86.10%and 97.22%(P<0.001).③Fifty-three of 88 children who referred the screening were diagnosed,accounting for 60.22%(53/88),1 child(5.88%)was diagnosed as unilateral mild to moderate sensorineural hearing loss,accounting for 1.69‰(1/590),16 children(48.48%)were diagnosed otitis media,20 children(37.74%)were normal.Conclusion Screening DPOAE is appropriate for 3~years old group,distortion otoacoustic emission and/or portable auditory assessor are appropriate for 4~6 year-old group.Questionnaires with good compliance but high false pass rate thus are recommended as a reference for medical history collection and screening.

关 键 词：儿童听力筛查 筛查型DPOAE 便携式听觉评估仪 配合度 通过率 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]