听力筛查未通过的新生儿听力损失的高危因素研究

目的:分析听力筛查未通过的新生儿听力损失的高危因素。方法:对43 568例新生儿出生后3～5天用耳声发射仪进行初筛,初筛未通过者在出生后42天内进行复筛,复筛未通过者在出生后3月内用脑干听觉诱发电位仪、声导抗、诊断型耳声发射进行听力障碍的诊断。结果:43 568例新生儿复筛未通过者802例,进行初次诊断者660例,占全部听力筛查儿的1.51%,其中256人出现不同程度的听力损失(含分泌性中耳炎导致的传导性听力损失),重度聋在听力筛查儿中的发生率为1.45‰。分泌性中耳炎发生率在听力损失组与听力正常组差异有统计学意义(χ2检验,P<0.01)。1∶1配对的病例对照多因素分析显示听力损失家族史是听力损失的独立危险因素。结论:听力筛查未通过的新生儿中,约一半听力损失伴有分泌性中耳炎,听力损失家族史是新生儿听力损失高危因素,应加强妇幼保健宣传教育,针对迟发性听力损失,应重视随访。

Study on high risk factors of neonatal hearing loss failing in hearing screening

Objective:To analyze the high risk factors of neonatal hearing loss failing in hearing screening.Methods:Primary screening was conducted in 43 568 neonates at 3-5 days after birth with distortion product otoacoustic emission(DPOAE),the neonates failing in primary screening received the second screening at 42 days after birth,then the neonates failing in the second screening received diagnosis of hearing loss within three months after birth with brainstem auditory evoked potential(BAEP),acoustic immitance,and DPOAE.Results:Among 43 568 neonates,802 neonates failed in the second screening,660 neonates received primary diagnosis,accounting for 1.51% of all the neonates,256 neonates were found with different degrees of hearing loss(including the neonates with conductive hearing loss induced by secretory otitis media),the incidence rate of severe deafness in neonatal hearing screening was 1.45‰.There was statistically significant difference in the incidence rate of secretory otitis media between hearing loss group and normal hearing group(P<0.01).Multivariate logistic regression analysis of 1∶ 1 paired case-control study showed that family history of hearing loss was one of independent risk factors of hearing loss.Conclusion:Among the neonates failing in hearing screening,about half of them have hearing loss combined with secretory otitis media,family history of hearing loss is one of high risk factors of neonatal hearing loss,maternal and child health care publicity and education should be strengthened,follow-up should be paid more attention to targeting to late-onset hearing loss.