对新生儿听力普遍筛查模式的研究

目的探讨开展新生儿听力普遍筛查的模式,获得新生儿听力损失发病的初步资料.方法采用耳声发射和脑干诱发电位两步筛查法.新生儿出生3～4d畸变产物耳声发射(DPOAE)进行初次听力筛查,出生42d时再次用同样方法对所有接受过初筛的婴儿进行复筛,复筛未通过者脑干诱发电位(ABR)诊断,异常者在6个月时再次复查ABR,两次ABR未通过者为听力损失.所有数据采用SPSS统计软件进行统计分析.结果住院期间筛查新生儿3944例,一次通过3242例,通过率82.2%,42d再次复查3284例,通过3167例,通过率96.4%,未通过117例中37例(31.6%)初筛通过.复筛未通过者ABR检查72例,有"例3个月内ABR未通过,至6个月时再次复查ABR,有20例转为正常,最后确诊不同程度听力损失7例,听力损失发病率1.77‰,其中1例DPOAE初筛通过.结论在我国开展新生儿听力筛查是完全可行的,住院期间普遍初筛和出生42d普遍复筛有利降低筛查假阴性和假阳性,两次ABR确诊有利提高诊断准确性,是较适合的模式,值得探讨和推广.新生儿听力损失发病率与文献报道相似.

The study of the model of universal newborn hearing screening

Objective To explore the universal newborn hearing screening model suitable in our country and acquire the basic data of incidence of newborn hearing loss.Methods All 3944 newborns received hearing screening test by distortion product otoacoustic emissions(DPOAE) in 72-96 hours and rescreened 42 days after they born. Those infants who failed to pass the rescreening test received auditory brainstem response (ABR) test in three month.Those infants who failed in the ABR test received ABR test again when they were in six month. All dates were analysis by SPSS 10.0 for windows. Results 3242(82.2%,3242/3944)newborns passed the DPOAE screening in the hospital. 3284 infants received DPOAE rescreening test and 3167(96.4%, 3167/3284)infants passed. 37 infants passed first screening test and failed in rescreening test . 27of 72 infants received ABR test failed to pass at their three month old, but 15infants passed ABR test in their six month old. 7 infants had been confirmed hearing loss.Conclusions It is feasible model to carry out in out country that two stage screening combined. It can reduce OAE false negative and false positive and increased the accurate of diagnosis.