2000例新生儿听力筛查结果分析

目的调查新生儿听力损失的发病情况。方法于2000例新生儿出生后72h，即应用耳声发射筛查仪对其双耳进行畸变产物耳声发射（DPOAEs）检查；初筛未通过者，42d后再次复查DPOAEs；复筛仍未通过者，进行听性脑干反应（ABR）检查；ABR检查不通过者，3～4个月内接受全面的听力学检查和评估，以确定其听力损失的性质和程度。结果接受初次筛查的新生儿中，1830例通过筛查，通过率为91．50％；初筛未通过的170例新生儿全部进行复筛，复筛通过者145例，通过率为85．29％；总通过率为98．75％，男女性别问差异无统计学意义（P〉0．05）；正常产儿初筛通过率为96．55％，高危儿初筛通过率为78．18％，差异有统计学意义（P〈0．01）。复筛未通过的25例中，经ABR及全面的听力学检查评估，确诊为先天性听力障碍者2例，听力缺陷率为1‰。结论高危儿中先天性听力缺陷发生率明显高于正常儿。宜及早应用畸变产物耳声发射技术对新生儿进行听力筛查，以及早发现新生儿听力缺陷并进行早期干预。

Hearing screening survey among 2 000 neonates

Objective To survey the distribution status of hearing disorder in the population of neonates based on a clinical epidemiological survey in a Hospital. Methods Included in this survey were 2 000 newborns received their first hearing screening test by the procedures of DPOAEs 72 hours after birth. Once anyone failed to pass the first screening program, re-screening test was performed to whom by the methods of DPOAEs after 42 days. When failed to pass the re-screening test once more, they should receive auditory brainstem response （ABR） test. If such cases failed to pass ABR test again, systematic auditory tests and assessments should be carried out among them within 3-4 months in order to definite the quality and degree of their hearing disorders. Results In this group of newborns, 1 830 （91.50%） passed the first DPOAEs screening test and the others did not. Among thel70 cases failed to pass the first screening test, 145 （85.29%） passed the re-screening test by DPOAEs, with a total passing rate of 98.75% in this population of neonates and with no statistically significant difference present between the sub-groups of male and female （P〉0.05）. However, the passing rate was 96.55% in the first- screening test among the normally born neonates, while it was 78.18% among the high-risk neonates, with statistically significant difference between them （P〈0.01）. Among the 25 cases who failed to pass the re-screening test, 2 were diagnosed with congenital hearing disorder following ABR and systematic auditory testing as the assessed result in this way, with a rate of 1‰ showing such a lesion. Conclusions The incidence of congenital hearing disorder is much higher in the population of high-risk neonates than that in the normally born neonates. Therefore, DPOAEs test procedures should be carried out among neonates for their hearing screening given as earlier as possible so as to diagnose the disorders of congenital heating defect as well as to interfere with such a condition properly as soon as possib