嘉兴市2019~2021年新生儿听力筛查、诊断、随访现状分析  

To Analyze The Status Of Hearing Screening,Diagnosis And Follow-up Of Newborns In Jiaxing City From 2019 To 2021

作　　者：薛秋霞 XUE Qiuxia(Jiaxing Maternal and Child Health Hospital,Jia xing,314000,China)

机构地区：[1]嘉兴市妇幼保健院,嘉兴314000

出　　处：《中华耳科学杂志》2024年第6期1044-1047,共4页Chinese Journal of Otology

摘　　要：目的分析嘉兴市新生儿听力筛查与诊断现状,从而获得影响听力诊断、随访的因素,从而提高新生儿听力筛查诊断质量。方法对2019年至2021年出生于嘉兴市五县两区需要开展听力检测的118513例新生儿进行初筛,初筛未通过者42 d内复筛,复筛未通过者转至市听力诊治机构,采用听性脑干反应(auditory brainstem response,ABR)、声导抗等方法检测,对异常者追踪随访。根据2019年至2021年嘉兴市新生儿听力筛查年度报表和随访结果,分析2019年至2021年嘉兴市新生儿听力筛查、诊断、随访现状以及主要的影响因素。结果2019年至2021年新生儿活产总数为118513例,实际完成初筛人数为118371例,初筛率为99.88%。初筛未通过12203例,复筛11953例,复筛率为97.95%,最终确诊异常429例,听力异常率为3.61‰。听力异常患儿经过随访发现,未复诊的患儿主要原因为:(1)失访:电话不正确或者未接听(41.43%,104/251);(2)上级医院进一步检查(25.10%,63/251);(3)家长认知不足,拒绝复诊(19.12%,48/251);(4)人员流动,已回老家(7.17%,18/251);(5)腭裂或存在耳朵畸形(7.17%,18/251)。结论2019至2021年嘉兴市新生儿听力初筛率维持在较高水平,虽然复筛率均满足考核条件,但对听力异常患儿的随访还不足。因此如何减少听力异常患儿的失访量、增加早期干预量将成为今后嘉兴听力筛查项目中的关键,也是听力筛查的终极目的。Objective To analyze the status of newborn hearing screening and diagnosis in Jiaxing City,so as to obtain the factors affecting hearing diagnosis and follow-up,so as to improve the quality of newborn hearing screening and diagnosis.Methods A total of 118,513,newborns who were born in five counties and two districts of Jiaxing city from 2019 to 2021 and needed hearing testing were initially screened.Those who failed the initial screening were screened again within 42 days.According to the annual report of newborn hearing screening and follow-up results in Jiaxing City from 2019 to 2021,the current situation of newborn hearing screening,diagnosis and follow-up in Jiaxing city from 2019 to 2021 and the main influencing factors were analyzed.Results From 2019 to 2021,the total number of live births was 118,513 and the actual number of completed primary screening was 118,371,the primary screening rate was 99.88%.Initial screening failed 12,203 cases,rescreened 11,953 cases,the rescreened rate was 97.95%,the final diagnosis of abnormal 429 cases,the abnormal hearing rate was 3.61‰.After follow-up,it was found that the main reasons for the children who did not return to the clinic were:(1)missing the follow-up:incorrect call or no answer(41.43%,104/251);(2)Further examination in superior hospital(25.10%,63/251);(3)Parents refused to return to the doctor due to lack of awareness(19.12%,48/251);(4)Staff turnover,have returned to their hometown(7.17%,18/251);(5)Cleft palate or ear deformity(7.17%,18/251).Conclusion From 2019 to 2021,the primary screening rate of newborn hearing in Jiaxing remained at a high level.Although the re-screening rate met the assessment conditions,the follow-up of children with hearing abnormalities was insufficient.Therefore,how to reduce the amount of lost follow-up of children with hearing abnormalities and increase the amount of early intervention will become the key in the future hearing screening program in Jiaxing,and it is also the ultimate purpose of hearing screening.

关 键 词：新生儿听力筛查 诊断 随访 影响因素 

分 类 号：R764[医药卫生—耳鼻咽喉科] R722.1[医药卫生—临床医学]