868例妇幼机构转诊儿童的听力学特征分析  

Analysis of clinical audiological characteristics in 868 children referred from maternal and child institutions

作　　者：李悦 文铖 程晓华[1] 于一丁 王川[2] 王璟[3] 傅新星[1] 刘辉[1] 刘冬鑫[1] 黄丽辉[1] LI Yue;WEN Cheng;CHENG Xiaohua;YU Yiding;WANG Chuan;WANG Jing;FU Xinxing;LIU Hui;LIU Dongxin;HUANG Lihui(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Otolaryngology,Key Laboratory of Otolaryngology Head and Neck Surgery,Capital Medical University,Ministry of Education,Beijing,100005,China;Maternal and Child Health Care Hospital of Chaoyang District;Department of Children's Health Care,Beijing Obstetrics and Gynecology Hospital,Capital Medical University)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科、北京市耳鼻咽喉科研究所、耳鼻咽喉头颈科学教育部重点实验室,北京100005 [2]北京市朝阳区妇幼保健院 [3]首都医科大学附属北京妇产医院儿童保健科

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第3期190-196,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金面上项目(No:81870730,82071064);首都卫生发展科研专项(首发2022-2-1092)。

摘　　要：目的:探讨妇幼机构转诊儿童的临床听力学特点及听力损失高危因素,为进一步完善儿童耳及听力保健工作提供科学依据。方法:研究对象为由北京市各妇幼机构转诊至首都医科大学附属北京同仁医院耳科门诊进行听力诊断的儿童共868例,均接受声导抗、听性脑干反应、畸变产物耳声发射等听力学测试。根据儿童确诊年龄分为0~<3月组(242例)、3~<6月组(328例)、6~<12月组(180例)和≥12月组(118例),对比分析各组听力诊断情况、听力损失程度和性质,以及高危因素与听力损失发生的关系。结果:868例儿童的确诊年龄为(7.13±8.29)个月。确诊听力损失488例(56.22%),听力正常380例(43.78%)。听力损失792耳,其程度占比由高到低依次为轻度366耳(46.21%)、中度214耳(27.02%)、极重度151耳(19.07%)、重度61耳(7.70%)。0~<3月组、3~<6月组、6~<12月组、≥12月组听力损失程度占比的差异均有统计学意义(P<0.001),组间两两比较,轻度占比0~<3月组高于其他三组(P<0.05),中度占比各组差异无统计学意义(P>0.05),重度占比≥12月组高于0~<3月组(P<0.05),极重度占比0~<3月组低于其他三组(P<0.05)。听力损失792耳中,感音神经性占67.42%,传导性和混合性分别占20.71%和11.87%。98例有听力损失高危因素者确诊听力损失58例(59.18%);高危因素者听力损失发生率由高到低分别为颅面畸形(93.75%),耳聋家族史/先天性遗传综合征(61.11%),NICU住院史(46.43%),其他(20.00%)。结论:妇幼机构转诊对轻至中度感音神经性听力损失儿童的早期发现具有重要作用;有颅面畸形、耳聋家族史/先天性遗传综合征、NICU住院史等高危因素者听力损失发生率高,应予以高度重视。Objective: To investigate the clinical audiological characteristics of children referred from maternal and child institutions and analyze the high risk factors of hearing loss, so as to provide scientific basis for further improvement of children’s ear and hearing care. Methods: The subjects of this study were 868 children who were referred by maternal and child institutions in Beijing to the otology outpatient of Beijing Tongren Hospital, Capital Medical University for hearing diagnosis. All subjects underwent acoustic immittance, auditory brainstem response, distortion products otoacoustic emission and other audiological tests. Children were divided into groups according to the age of diagnosis: 0-<3 months group(242 cases), 3-<6 months group(328 cases), 6-<12 months group(180 cases), ≥12 months group(118 cases), the results of hearing diagnosis, hearing loss degree and types, the relationship between high risk factors and hearing loss in each group were compared and analyzed. Results: The age of diagnosis of 868 children was(7.13±8.29) months. 488 cases with hearing loss accounted for 56.22% and 380 cases with normal hearing accounted for 43.78%. Proportion of different degree of hearing loss of 792 ears from high to low was as follows: mild, 366 ears(46.21%);moderate, 214 ears(27.02%);severe, 151 ears(19.07%);profound, 61 ears(7.70%). There were statistically significant differences in the proportion of different hearing loss degree among 0-<3 months group, 3-<6 months group, 6-<12 months group and ≥12 months group(P<0.001). Pairwise comparison between groups showed that the proportion of mild hearing loss of 0-<3 months group was higher than that in the other three groups(P<0.05), there was no significant difference of moderate hearing loss among all groups(P>0.05), the proportion of severe hearing loss of ≥12 months group was higher than that of 0-<3 months group(P<0.05). The proportion of profound hearing loss with 0-<3 months group was lower than the other three groups(P<0.05). In 792 ears with h

关 键 词：妇幼机构 儿童 耳及听力保健 听力损失 高危因素 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]