比较畸变产物耳声发射与听性脑干反应应用于新生儿听力筛选的敏感性研究  

Sensitivity of distortion product otoacoustic emissions and auditory brain-stem response in neonatal hearing screening, a comparative study

作　　者：许政敏[1,2] 李瑾[1,2] 胡天真[1,2] 孙建华[1,2] 沈晓明[1,2] 

机构地区：[1]上海第二医科大学附属新华医院 [2]上海儿童医学中心,200092

出　　处：《中华医学杂志》2003年第4期278-280,共3页National Medical Journal of China

摘　　要：目的 比较畸变产物耳声发射(DPOAE)及听性脑干反应(ABR)技术应用在新生儿听力筛选的敏感性。方法 对在上海第二医科大学附属上海儿童医学中心重症监护病房的99名新生儿(198耳),采用DPOAE及ABR技术进行听力初筛、复筛、以及确诊。结果 在所有198耳检测DPOAE中,有54耳(27％)未通过初筛。经复筛仍有14耳(7％)未通过。另外,26耳(12％)未通过ABR初筛,对未通过ABR初筛的进行复查,仍有9耳(4.5％)未通过。最后经诊断性听性脑干反应及声导抗检查,确诊2例患重度感觉神经性聋,1例为双侧性,一例为单侧性。ABR和DPOAE听力筛查的敏感性分别为99％及97％。结论 ABR技术在新生儿听力筛查的敏感性略高于DPOAE方法。采用二次筛查方法,可提高听力筛查的感性。选择新生儿听力筛查技术,不但考虑筛查技术的敏感性,而且要综合考虑其方便性、快速性、以及成本。Objective To investigate the sensitivity of distortion product otoacoustic emissions (DPOAE) and auditory brain-stem response (ABR) in neonatal hear ing screening. Methods DPOAE and ABR were conducted on 99 neonates (198 ears) at risk of hearing impairment as initial screening tests. One month later rescreening tests were conducted: DPOAE was conducted again on those ears failing this test during the initial screening test and ABR was conducted again on the ears failing this test during the initial screening test Those ears failing the DPOAE and ABR tests during the rescreening tests were examined with electric otoscope, diagnostic ABR, etc. to get confirmed diagnosis. Results 54 ears (27% ) failed the DPOAE test during the initial screening and 14 out of the 54 ears (14/198, 7% ) still failed the DPOAE test during the rescreening. 26 ears (12% )failed the ABR test during the initial screening and 9 out of the 16 ears (9/198, 4.5%) still failed this test during the rescreening. Two babies were confirmed as with severe sensorineural hearing loss, one unilateral and one bilateral. The sensitivity was 97% for DPOAE and 99% for ABR. Conclusion ABR is a little bit more sensitive then DPOAE in neonatal hearing screening. Two-stage testing procedure increases the sensitivity of neonatal hearing screening.

关 键 词：畸变产物耳声发射 听力筛选 加强医疗病房 新生儿 耳声发射 脑干听觉诱发电位 

分 类 号：R174[医药卫生—妇幼卫生保健]