短声听性脑干反应结合耳声发射在神经性聋患儿听力筛查评估中的应用价值  

Application value of click-evoked auditory brainstem response combined with otoacoustic emission in the evaluation of hearing screening in children with neurological deafness

作　　者：黄惠玲 谢婷 李彩云 杨凌鹏 HUANG Huiling;XIE Ting;LI Caiyun;YANG Lingpeng(Department of Otolaryngology,Ganzhou Maternal and Child Health Hospital,Jiangxi Province,Ganzhou 341099,China;Department of Child Health,Ganzhou Maternal and Child Health Hospital,Jiangxi Province,Ganzhou 341099,China)

机构地区：[1]江西省赣州市妇幼保健院耳鼻喉科,江西赣州341099 [2]江西省赣州市妇幼保健院儿童保健科,江西赣州341099

出　　处：《中国当代医药》2022年第35期128-131,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220217776);江西省赣州市科技计划项目(GZ2021ZSF298)。

摘　　要：目的研究短声听性脑干反应(c-ABR)结合耳声发射(OAE)在神经性聋患儿听力筛查评估中的应用价值。方法选取2021年8月至2022年2月赣州市妇幼保健院出生后OAE初筛未通过的100例患儿作为研究对象,均行c-ABR、OAE听力筛查,所有参与筛查的新生儿3个月后依据声阻抗检查和常规脑干诱发电位(ABR)检查为金标准,评估是否存在神经性聋,结合诊断结果,判断c-ABR+OAE筛查神经性聋的诊断效能。结果42 d复筛100例患儿,c-ABR检查中,51例(51.00%)引出V波,49例(49.00%)未引出V波;OAE检查中,通过52例(52.00%),未通过48例(48.00%)。c-ABR+OAE检查的准确度为91.00%,灵敏度为98.36%,高于c-ABR单独检查(75.00%、72.13%)、OAE单独检查(75.00%、73.77%),漏诊率为1.64%,低于c-ABR单独检查(27.87%)、OAE单独检查(26.23%),差异有统计学意义(P<0.017)。结论c-ABR+OAE检查应用于神经性聋患儿筛查,鉴别诊断灵敏度、准确度较高,对新生儿听力障碍的临床诊断、早期针对性治疗、预后改善均具有临床指导意义。Objective To study the application value of click-evoked auditory brainstem response(c-ABR)combined with otoacoustic emission(OAE)in the assessment of hearing screening in children with neurological deafness.Methods A total of 100 infants who failed the initial OAE screening after birth in Ganzhou Maternal and Child Health Hospital from August 2021 to February 2022 were selected as subjects,and they all underwent c-ABR and OAE hearing screening.Acoustic impedance examination and routine auditory brainstem response(ABR)examination were used as the gold standard to evaluate the presence of neurological deafness.Combined with the diagnostic results,the diagnostic efficacy of c-ABR+OAE in screening neurological deafness was judged.Results Among the 100 children who were rescreened on 42 days,51 children(51.00%)had V waves and 49 children(49.00%)had no V waves in c-ABR examination.In the OAE examination,52 children(52.00%)passed and 48 children(48.00%)failed.The accuracy of c-ABR+OAE examination was 91.00%and the sensitivity was 98.36%,which were higher than those of c-ABR alone examination(75.00%,72.13%)and OAE alone examination(75.00%,73.77%),and the missed diagnosis rate was 1.64%,which was lower than that of c-ABR alone examination(27.87%)and OAE alone examination(26.23%),with statistically significant differences(P<0.017).Conclusion c-ABR+OAE examination is applied in the screening of children with neurological deafness,with high sensitivity and accuracy in differential diagnosis,and has clinical guiding significance for clinical diagnosis,early targeted treatment and prognosis improvement of neonatal hearing impairment.

关 键 词：短声听性脑干反应 耳声发射 神经性聋 诊断效能 

分 类 号：R174[医药卫生—妇幼卫生保健]