OAE+AABR联合筛查模式在新生儿听力复筛中的应用价值  

Application of otoacoustic emission combined with auto-auditory brainstem response in newborn hearing screening

作　　者：王俊姬 王文静 薛泽恩 冯爱民[3] WANG Jun-ji;WANG Wen-jing;XUE Ze-en;FENG Ai-min(Department of Neonatology,Xi'an Angel Maternity Hospital,Xi'an 710061,Shaanxi,CHINA;Department of Neonatology,Xi'an International Medical Center,Xi'an 710061,Shaanxi,CHINA;Department of Neonatology,First Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi,CHINA)

机构地区：[1]西安安琪儿妇产医院新生儿科,陕西西安710061 [2]西安国际医学中心新生儿科,陕西西安710061 [3]陕西中医药大学第一附属医院新生儿科,陕西咸阳712000

出　　处：《海南医学》2023年第21期3147-3150,共4页Hainan Medical Journal

摘　　要：目的研究耳声发射(OAE)+自动听性脑干反应(AABR)联合筛查模式在新生儿听力复筛中的应用效果。方法回顾性分析2018年1月1日至2021年12月31日在西安安琪儿妇产医院产科出生的600例(1200耳)OAE初筛未通过的新生儿的临床资料。所有新生儿的初筛时间为出生后2 d内,再次筛查时间为出生后45 d内。比较OAE、AABR两种检查的复筛结果,并观察最终的听力诊断结果。结果初筛异常的600例(1200耳)新生儿中,1000耳(单耳40例,双耳480例)OAE和AABR检查结果均通过,通过率为83.33%(1000/1200);126耳(单耳30例,双耳48例)OAE与AABR检测均未通过,占比为10.50%(126/1200);OAE通过而AABR未通过有8耳(双耳4例),占比为0.67%(8/1200),OAE未通过而AABR通过有66耳(单耳54例,双耳6例),占比为5.50%(66/1200)。600例(1200耳)中44例(76耳)在3个月龄时被确诊分泌性中耳炎,其中20耳在OAE及AABR复筛时均通过,对初筛OAE未通过的新生儿家属进行病史询问,初筛时有感冒、流涕的病史,考虑在初筛时可能有分泌性中耳炎,而复筛时已经痊愈恢复正常;4例8耳为小儿听神经病;14耳(双耳6例,单耳2例)属于大前庭导水管综合征,通过耳聋基因检测筛查结果显示SLC26A4基因有突变,CT平扫颞骨验证后确诊;76耳(双耳32例,单耳12例)为感音神经性聋,其中8耳为中重度听力损失,8耳为重度听力损失,40耳为极重度听力损失;46耳(单耳2例,双耳22例)听力正常。结论OAE联合AABR检查法进行新生儿听力复筛能够有效补充单一筛查所存在的不足,可在很大程度上降低新生儿听力筛查漏诊率的假阳性率。Objective To study the effect of otoacoustic emission(OAE)combined with autoauditory brainstem response(AABR)in newborn hearing screening.Methods The clinical data of 600 newborns(1200 ears)who were born from January 1,2018 to December 31,2021 in the Department of Obstetrics at Xi'an Angel Maternity Hospital and did not pass the initial screening of OAE were retrospectively analyzed.The initial screening time of all newborns is within 2 days after birth,and the second screening time is within 45 days after birth.The screening results of OAE and AABR were compared,and the final hearing diagnosis results were observed.Results Among the 600 cases(1200 ears)with abnormal results in the initial screening,1000 ears(40 cases in one ear and 480 case in both ears)passed the examination of OAE and AABR,with a passing rate of 83.33%(1000/1200);126 ears(30 cases in one ear and 48 cases in both ears)did not pass OAE and AABR,accounting for 10.50%(126/1200);there were 8 ears(4 in both ears)that passed OAE and failed AABR,accounting for about 0.67%(8/1200);there were 66 ears(54 in one ear and 6 in both ears)that failed OAE and failed AABR,accounting for 5.50%(66/1200).Of the 600 cases(1200 ears),44(76 ears)were diagnosed with secretory otitis media at the age of 3 months,of which 20 ears passed the screening of OAE and AABR.The family members of newborns who failed the initial screening of OAE were inquired about the medical history.There was a history of cold and runny nose at the initial screening.It was considered that there might be secretory otitis media at the initial screening,but it had recovered and returned to normal at the screening;4 cases(8 ears)were children's auditory neuropathy;14 ears(6 in both ears and 2 in one ear)belong to large vestibular aqueduct syndrome.The results of deafness gene detection and screening showed that SLC26A4 gene was mutated,and the diagnosis was confirmed after the verification of CT plain scan of temporal bone;76 ears(32 in both ears,12 in one ear)were sensorineural hearing loss,of whi

关 键 词：新生儿 耳声发射 自动听性脑干反应 联合 听力复筛 

分 类 号：R722.1[医药卫生—儿科]