瞬态声诱发耳声发射在筛查新生儿听力中的应用

耳声发射是一种产生于耳蜗经听骨链及鼓膜传导释放入外耳道的音频能量,它是目前新生儿听力筛查的首选且有效方法。我们应用瞬态声诱发耳声发射(transient-evoked otoa-coustic emissions,TEOAE)对新生儿听力进行筛查,并讨论其临床应用。     

瞬态诱发耳声发射用于黄疸新生儿听力筛查

目的探讨瞬态诱发耳声发射（TEOAE）对黄疸新生儿听力筛查的临床意义。方法应用丹麦Madsen Accscreen全功能听力筛查仪对130例黄疸新生儿（黄疸组）及150例健康新生儿（对照组）进行瞬态诱发耳声发射检查，3个月后复查，对于未通过者，同时进行自动听性脑干反应检查（AABR）。结果黄疸新生儿通过率为84．6％，健康新生儿通过率为92．0％，两组比较有显著意义（P〈0．01）。3个月复查时有一例黄疸新生儿双耳未通过TEOAE检查。结论TEOAE检查是一种快速、有效、安全的新生儿听力筛查方法之一。     

瞬态诱发耳声发射在新生儿听力筛查中的应用

目的：探讨瞬态诱发耳声发射(TEOAE)在新生儿听力筛查中的可行性及临床意义。方法：对126(252耳)名正常新生儿在出生后第7天、第30天及3个月，分别进行TEOAE检查及ABR测试并对两者的结果进行科学分析。结果：TEOAE通过率随着出生后时间的增长分别为90.4％、96％、96.4％。与ABR结果对照其共同阳性率为100％，共同阴性率分别是因为3％、97.5％、97.9％。结论：TEOAE是一种快速、敏感、无创、简便易行的听力筛查手段。     

瞬态诱发耳声发射在新生儿听力普遍筛查中的应用

目的 （1）评价瞬态诱发耳声发射（TEOAEs)在新生儿听力普遍筛查中应用的可行性。（2）建立新生儿听力普遍筛查模式。方法 对2094例新生儿（占全体96．23％），出院前行TEOAEs测试，术通过1个月后复查TEOAEs，仍未通过随后行听性脑干反应（ABR）检查，对通过OAE筛查的高危因素登记（HRR）新生儿定期随访。ABR检查不通过在3个月内接受全面的听力学诊断和评估。结果 1897例（90．59％）通过出院前筛查；1个月后191例复查，176例（92．15％）通过，15例接受ABR检查，5例未通过（33．3％）。最后确诊6例婴儿（2．87‰）有听力损失。结论 应用TEOAEs进行新生儿听力普遍筛查是切实可行的。筛查模式就是对筛查，跟踪和随访诊断，干预以及评估5项内容的具体实施。TEOASEs联合ABR三步法是适宜的筛查策略。对通过OAE测试的HRR婴儿定期随访。     

瞬态诱发耳声发射对新生儿听力筛查的结果分析

目前,瞬态诱发性耳声发射对新生儿听力筛查的研究较多,其可行性已被大家所认同.现对本院2576例行听力筛查进行分析,报告如下.     

瞬态诱发耳声发射对新生儿听力筛查的应用价值

目的 用瞬态诱发性耳声发射(transient evoked otoacoustic emissions,TEOAE)对新生儿进行普遍听力筛选，探讨其应用价值；方法 用英国otodynamic公司生产的ILO—92耳声发射仪进行测试，刺激声为疏波短声，声刺激强度为73—86dBSPL，脉冲宽度80μS，刺激方式为“3 1”(3个正相波后紧接一个3倍振幅的负相波)非线性模式。结果 共有2596例小儿进入TEOAE听力筛选；12例诊断为双耳轻、中度听力下降，6例单耳听力下降，12例传导性听力下降。结论 TEOAE能发现感音性聋和传导性听力下降，是快速、简单、客观、无创的听力筛查技术。     

瞬态诱发耳声发射在新生儿听力筛查中的应用

耳声发射是一种产生于耳蜗,经听骨链及鼓膜传导释放入外耳道的音频能量.以短暂声刺激诱发产生的耳声发射称为瞬态诱发耳声发射.该检查方法客观、敏感、无创,在新生儿的听力筛查中具有较大的应用价值.现就瞬态耳声发射及其在新生儿听力筛查中的应用进行综述.     

瞬态诱发耳声发射在新生儿听力筛查中的应用

目的探讨瞬态诱发耳声发射（TEOAE）在新生儿听力筛查中的应用价值。方法采用丹麦公司生产的手持式耳声发射仪,对出生3d后的新生儿在同样的条件下,对同一只耳朵分别行“瞬态诱发耳声发射（TEO—AE）”与“畸变产物耳声发射（DPOAE）”的检测,并对检测所需要的时间和结果进行统计学处理。结果瞬态诱发耳声发射（TEOAE）与畸变产物耳声发射（DPOAE）对新生儿听力测试的结果是一样的,无任何差异。而测试所需要的时间则为TEOAE比DPOAE明显缩短（P〈0．01）。结论瞬态诱发耳声发射（TEOAE）以更加快速、简便、安全、无创、具有客观性为优势,作为新生儿听力筛查的一项常规技术方法,值得广泛推广、应用。     

瞬态诱发耳声发射在新生儿听力普遍筛查中的应用

目的(1)评价瞬态诱发耳声发射(TEOAEs)在新生儿听力普遍筛查中应用的可行性。(2)建立新生儿听力普遍筛查模式。方法对2094例新生儿(占全体96.23%)出院前行TEOAEs测试,未通过者1个月后复查TEOAEs,仍未通过者随后行听性脑干反应(ABR)检查,对通过OAE筛查的高危因素登记(HRR)新生儿定期随访。ABR检查不通过者在3个月内接受全面的听力学诊断和评估。结果1897例(90.59%)通过出院前筛查;1个月后191例复查,176例(92.15%)通过,15例接受ABR检查,5例未通过(33.3%)。最后确诊6例婴儿(2.87‰)有听力损失。结论应用TEOAEs进行新生儿听力普遍筛查是切实可行的。筛查模式就是对筛查、跟踪和随访、诊断、干预以及评估5项内容的具体实施。TEOAEs联合ABR三步法是适宜的筛查策略。对通过OAE测试的HRR婴儿定期随访。     

瞬态耳声发射在新生儿听力筛查中的应用

目的：探讨瞬态耳声发射（TEOAE）在新生儿听力筛查中的应用。方法：应用TEOAE对1780名新生儿进行听力筛查，以外耳道记录到耳声发射反应为通过标准。结果：初筛通过率为81．91％，测试时间以生后2天以上为佳。结论：TEOAE测试快速、无创、客观、灵敏、经济。值得在基层医院推广应用，可作为首选筛查手段。     

Resonant modes of otoacoustic emissions

Transiently evoked otoacoustic emission (TEOAE) signals were decomposed into basic components by means of the matching pursuit algorithm. The components were characterized by frequency, latency, time span and energy. The resonant modes characteristic for each person/ear were identified. A high time-frequency resolution of the method and the parametric representation of the waveforms made possible estimation of the frequency ratios of the resonant modes. The repetitive occurrence of the 'fifth', 'fourths' and octaves connected with the Pythagorean temperament was found. The significance of the results was confirmed by comparison to Monte Carlo simulations of the null hypothesis of a random distribution of frequency modes. These findings are in agreement with the resonance theory of hearing, which binds musical ratios with the geometrical spacing of outer hair cells in cochlea.     

顺态诱发耳声发射在新生儿听力筛查中的应用

目的 评价顺态诱发耳声发射在新生儿听力筛查中应用的重要性、可行性,了解新生儿听力损失的发病状况,以便早期干预.方法 应用顺态诱发耳声发射对2915例新生儿进行听力初筛、复筛,外周听力在刺激频率范围内正常表示筛查通过.初筛未通过行复筛,复筛未通过者采用听觉脑干诱发电位技术诊断.结果 2915例中初筛通过2587例,需要复筛328例,实际复筛298例,通过286例;确诊为听力损失4例(7耳),新生儿先天性听力损失在筛查儿中发病率为1.37‰.结论 应用顺态诱发耳声发射可及早发现新生儿听力损失,并进行及早干预,促进婴幼儿语言发育.     

瞬态诱发性耳声发射与自动听性脑干反应联合应用对新生儿听力筛查的临床意义

目的探讨瞬态诱发性耳声发射(transient evoked otoacoustic emission,TEOAE)和自动听性脑干反应(auto-mated auditory brainstem response,AABR)联合应用在新生儿听力筛查中的意义。方法对攀枝花学院附属医院出生3~5天的2869例(5738耳)新生儿给予TEOAE进行初筛,未通过者在出生后42天联合应用TEOAE和AABR复筛。结果在新生儿听力初筛中,共有311例新生儿(10.84%)未通过,复筛中28例(14.34%)未通过。结论 TEOAE与AABR联合测试技术可以广泛运用于新生儿听力筛查,可对听力障碍儿童早发现、早干预,有利于提高新生儿语言和认知能力。     

瞬态诱发耳声发射结果的影响因素分析

[目的]了解对早产听力筛查结果的影响因素及降低假阳性率、提高筛查通过率的规范方法。[方法]正常足月新生儿896例,分为两组,按一定的操作要求执行瞬态诱发耳声发射操作,分析影响听力筛查通过率的各个因素。[结果]发现48h～72h执行筛查的通过率与72h后执行有明显差异。耳道分泌物多的通过率低于分泌物少的新生儿,体位对通过率无明显差异。[结论]新生儿听力筛查极其重要,对影响听力筛查的因素及时纠正,能提高筛查通过率,降低假阳性率。早期发现、及时干预可使听力障碍患儿在幼时的听力与语言功能健康发展。     

瞬态诱发耳声发射结果的影响因素分析

[目的]了解对早产听力筛查结果的影响因素及降低假阳性率、提高筛查通过率的规范方法.[方法]正常足月新生儿896例,分为两组,按一定的操作要求执行瞬态诱发耳声发射操作,分析影响听力筛查通过率的各个因素.[结果]发现48 h～72 h执行筛查的通过率与72 h后执行有明显差异.耳道分泌物多的通过率低于分泌物少的新生儿,体位对通过率无明显差异.[结论]新生儿听力筛查极其重要,对影响听力筛查的因素及时纠正,能提高筛查通过率,降低假阳性率.早期发现、及时干预可使听力障碍患儿在幼时的听力与语言功能健康发展.     

Age and gender differences in health services utilization

The purpose of this study was to examine the health service utilization patterns of elderly male and female enrollees of a large urban staff model Health Maintenance Organization (HMO). This HMO offered a wide spectrum of managed care services for its beneficiaries. A cross-sectional design was employed. The 759 randomly sampled elderly enrollees ranged in age from 66 to 99, with an average of 77.15 years. Approximately 60% were male and 40% were female; thus, the sample was not representative of the national older adult population. Three utilization patterns indicated that there were (a) nonsignificant relationships between age or gender and urgent care visits, prescribed pharmaceuticals, and out-of-pocket costs for pharmaceuticals; (b) linear relationships between age and gender and visits to HMO primary care providers (−), home-health care visits (+), emergency care visits (+), hospitalizations (+), and MD visits during hospitalizations (+); and (c) age was curvilinearly related to use of both HMO specialists and non-HMO specialists. These findings suggest that use of acute care services, including hospitalizations, inpatient physician visits, and emergency services increase with age but the use of primary care providers decreases with age. Gender was not a significant modifier of the relationship between age and utilization. © 1996 John Wiley & Sons, Inc.     

Age and gender differences in seven tests of functional mobility

Background  

The objective of this study was to examine age and gender differences in seven tests of functional mobility.     

Are there gender differences in pain perception?

Chronic pain conditions are increasingly prevalent. However, very little is known about the relationship between pain and gender. The purposes of this study were to determine gender differences in pain threshold and tolerance among Chinese adults in Hong Kong and to examine the role of anxiety in pain perception. One hundred seventy-eight healthy, pain-free adults (89 men and 89 women) were recruited from a local university by convenience sampling to participate in the study. All participants completed the State and Trait Anxiety Inventory and underwent a laboratory pain task to determine their pain threshold and tolerance levels. Pain was assessed by using the Pain Intensity Verbal Rating Scale-Chinese version. Compared to men, women had a lower threshold (p < .001) and tolerance (p < .001) for pressure pain, and women reported more pain (p < .01) at the pain tolerance level. Higher trait anxiety scores were associated with higher pain report in men only (r [89] = .22, p = .04). The study indicated that gender differences in pain perception exist among the Chinese population in Hong Kong. A better understanding of the factors that contribute to gender differences in pain perception could reduce gender bias in pain management.     

新生儿畸变产物耳声发射检出率的动态分析

目的探讨畸变产物耳声发射（distortionproductaeousdcemission，DPOAE）用于新生儿听力筛查的最佳时机。方法对我院产科病房三个月内出生的100例新生儿（200耳）进行DPOAE测试。测试前详细登记新生儿及父母的自然状况。测试在新生儿处于安静状态下进行。对每一名受试对象进行9次DPOAE测试，测试时机分别为出生后1、2、3、4、5、6、7、15及第30天。应用SPSS统计软件进行统计学处理。结果①DPOAE测试通过耳数及通过率随着日龄的增加而上升。第1天通过耳数接近一半（47％），第4天达到了90％以上。②在DPOAE通过率日龄曲线中，前三个时间点处的斜率较大，波形较陡。曲线在第4天以后相对平缓，DPOAE通过率趋于饱和。③在相邻日龄新生儿DPOAE通过率的比较中，前三组的P值均〈0．05，通过率有显著性差异，后四组的P值均〉0．05，通过率差异无统计学意义。结论①DPOAE测试非常适合于大规模的新生儿听力筛查，尤其是初筛。②DPOAE测试结果尚不足以做为金标准进行听力学诊断，必要时需结合ABR及声阻抗等检查。③DPOAE测试用于新生儿听力筛查的最佳时机为不应少于出生后4d。