1-3岁小儿语言发育迟缓筛查量表北京市常模制订

目的:为了早期识别、诊断幼儿语言发育迟缓,制订一套适用于小年龄儿童的语言发育迟缓筛查量表。方法:根据2000年北京市人口普查资料,对北京各个 城区儿童以年龄,性别等因素按比例分层抽样方法,共抽取了1-3岁儿童582倒。对量表进行了信度和效度的研究;计算了各分测验之间和各分测验和总得分间相关系数。 结果:各个条目及总量表具有适当的难易程度和较好的鉴别力;量表的项目定位基本合理;信度和效度研究显示各分量表及总量表具有较高的信度和效度,符合心理测量学 的要求。结论:小儿语言发育迟缓筛查量表具有良好的信度和效度,临床上可以使用该量表筛查出语言发育迟缓儿童并对他们进行鉴别诊断。     

珠海市基层医院新生儿听力筛查工作调查

目的 调查珠海市基层医院新生儿听力筛查工作开展现状及信息化管理模式运行情况,探讨进一步提升新生儿听力筛查质量及信息化管理水平的新模式.方法 采用现场填写质控评分表、面向各医院听力筛查负责人发放调查问卷等方式,对珠海市24家助产医疗保健机构新生儿听力筛查工作进行质控,调查筛查工作普及状况、筛查率、转诊率及信息化管理现状.结果 ①2014年全市新生儿分娩量30 808人,听力初筛25 295人,筛查率82.11%(25 295/30 808).其中14家已开展听力筛查医院中有10家医院初筛率达95%以上,另外4家医院的初筛率分别为93.02%、66.79%、55.29%、48.37%;10家未全面开展听力筛查医院转诊率低于40%,各医院新生儿听力筛查工作开展情况差距较大. ②全市2014年新生儿听力初筛阳性率9.34%(2 363/25 295),复筛阳性率7.98%(145/1 816),接受听力学诊断193人(64.14%,93/145);最后确诊双耳听力异常30人,新生儿听力损失检出率0.12%(30/25 295);需进行耳聋干预8人,其中6人已接受医学干预,干预率为75%(6/8).③珠海市听力筛查信息化工作已推行近十年,但听力筛查系统使用情况不佳,没有充分发挥信息化管理的优势. 结论 基层医院新生儿听力筛查工作不仅要重视筛查率,更要提高筛查未通过者的复筛率、诊断率、干预率和回访率等,利用信息化管理的优势加强对听力损失高危儿及听力障碍者的长期跟踪随访,以提高听力筛查整体质量.     

《中小学生听力筛查量表》信度和效度研究

目的评价《中小学生听力筛查量表》的信度和效度，为轻、中度听力损失儿童的筛查工作提供可靠依据。方法随机抽取北京市房山区闫村小学和大董村小学共610名学生，年龄在6～15岁之间，由调查人员采用编制的听力筛查量表对每名儿童进行询问式调查，回收问卷进行信度分析；另选取1017名儿童进行预试验，35名已确诊的听力损失儿童来自中国聋儿康复研究中心门诊部，听力阈值在31～80dBHL，982名经过测试且听力正常的儿童来自北京市平谷区第四小学，对所有儿童分别进行询问式问卷调查和纯音测听（采用GVSLN--PC2B听力计测试），以纯音测听结果作为“金标准”，以问卷调查总分是否为0作为筛查标准评价量表的真实性。结果13个指标的重测相关系数在0．90～1．00之间，分半信度为0．83，Cronbach’s alpha系数为0．82；总体得分相关系数为0．94，准则关联效度为0．90（P=0．000），灵敏度为94．29％，特异度为90．43％。结论《中小学生听力筛查量表》具有较好的可行性与有效性，该量表整体符合量表编制的基本要求，建议进一步推广试用。     

2017～2019年广东省新生儿听力初筛、复筛、随访现况及影响因素

目的 调查广东省新生儿听力筛查的现状,并探讨复筛、随访的影响因素.方法 对来自广东省各市的195家相关医疗机构中195例从事新生儿听力筛查的工作人员进行2017年至2019年新生儿听力筛查初筛率、复筛率、失筛原因、失访率及对目标人群随访情况的问卷调查,并结合2017年至2019年广东省新生儿听力筛查年度报表及相关文献资...     

新生儿听力筛查资料管理和随访系统介绍

目的 通过网络数据库保存和管理新生儿听力筛查、诊断和干预康复资料,并自动完成发送和接收短信对新生儿家长进行跟踪随访,探讨该系统在新生儿听力筛查中的应用价值.方法 对新生儿听力筛查、听力学诊断和干预康复资料通过互联网环境下的医生工作平台录入新生儿听力筛查资料管理系统.用户名为新生儿家长手机号,听力筛查、诊断结果输入数据库提交后,系统按照检查、诊断结果分类,自动识别需要复诊患儿,定时自动获取用户名,提交到移动、联通、网通等网关接口,群发短信通知患儿家长下次复诊时间,同时接收患儿家长短信回复.患儿家长凭收到网址、帐号、密码使用任何一台接入互联网的电脑访问该系统的网站,查询历次听力筛查诊断结果和耳聋十预方法、语言康复结果等,并可在线咨询听力等相关问题.结果 新生儿听力筛查资料管理和随访系统具有随时随地查询功能,具有统计报表功能,实现多方面数据检索功能,并可转换成EXCEL,方便统计软件分析处理.系统实现定时自动获取用户名,分类自动群发短信通知患儿家长复诊时间,家长可直接回复短信.系统发送和接收的短信自动存入对应患儿资料库中,方便日后医疗纠纷时调出查阅.结论 新生儿听力筛查资料管理和随访系统能满足新生儿听力筛查-诊断-干预-康复-随访-质最控制一体化功能,系统自动短信发送和接收,实现听力筛查数据库智能管理,解决临床听力筛查随访难题.接受家长听力相关问题网络提问,向电子商务方向拓展.     

30835例新生儿听力和基因联合筛查实践研究

目的通过新生儿听力和耳聋基因联合筛查及听力学诊断结果分析,进一步明确联合筛查的意义。方法以2013年7月至2015年6月间出生普通产科出生活产新生儿为研究对象,出生48小时后进行新生儿听力初筛,同时采集足跟血进行耳聋基因筛查。初筛未通过者42天回产院复筛。复筛仍未通过者及耳聋基因筛查未通过者均于3月龄转诊至6家儿童听力障碍诊治机构接受听力诊断性检测和遗传咨询服务。通过对采集的联合筛查及听力诊断数据信息加以统计分析,开展研究。结果 30835例新生儿接受了听力和耳聋基因的联合筛查,联合筛查率占同期活产新生儿的97.6%,联合筛查推广和执行力度较为充分,社会认同度高。其中听力两步筛查未通过率1.51%,。耳聋基因筛查未通过率4.73%。联合筛查显示耳聋基因筛查未通过群体中听力筛查的未通过率(3.8%)高于基因筛查通过者(1.4%),P<0.001,提示听力筛查和耳聋基因筛查未通过者互为联合筛查的高危人群。1457例耳聋基因筛查未通过者中GJB2基因突变者占比最高(55.4%),其235del C位点突变最为常见(72.5%),其次是SLC26A4基因(34.3%)。线粒体12s r RNA基因突变共74例(5.1%)。1457例中共发现纯合和复合杂合突变5例,4例明确听力损失。单杂合突变1452例,检出不同程度听力损失14例。结论实践证明新生儿听力和耳聋基因联合筛查可行性强,临床应用易于推广。新生儿听力和耳聋基因筛查联合开展,相互裨益,是目前防聋筛查的最佳模式。     

婴幼儿助听器验配

新生儿听力筛查工作已在我国广泛开展,并取得了初步成效.众所周知,新生儿听力筛查工作包括听力筛查、早期诊断评估和干预、听觉言语和语言康复训练以及后期的追踪随访等诸多环节.目前,我国早期听力诊断评估及早期干预工作仍存在着严重的不足,尤其是早期干预质量堪忧.因此针对早期听力干预问题,应该制定相应的技术规范,以提高干预的力度和质量.     

珠海市新生儿听力筛查开展状况调查

目的 调查珠海市新生儿听力筛查开展现状及筛查技术准入落实情况,为进一步规范新生儿筛查工作提供依据.方法 对珠海市26家分娩医院进行实地现况调查,对各医院新生儿听力筛查原始数据进行统计分析,向负责听力筛查的技术人员发放26份听力筛查技术准入制度现况调查问卷,收回有效问卷26份,对相关数据进行汇总分析.结果 珠海市26家分娩医院中,开展听力筛查12家,年分娩量约2.3万人次,占全市分娩量的90.8%;未开展听力筛查、实行转诊的医院11家,年分娩量约0.2万人次,占全市分娩量的9.2%;未开展听力筛查、也无转诊医院2家,年分娩量约100人次;还有1家医院变更资质,已无分娩量.全市2011年新生儿听力筛查率在90%左右.调查发现各医院听力筛查方法不统一,部分医院筛查人员无资质,个别医院筛查环境差等.结论 珠海市新生儿听力筛查开展状况存在诸多不足,筛查结果可靠性有待进一步提高.     

我国婴幼儿“早期听力检测及干预指南”编写思考

新生儿早期听力检测及干预项目包括听力筛查、诊断和干预,是一项系统化和社会化的优生工程,具有深远的社会意义.自2004年12月我国卫生部颁布[2004]439号文件,正式将"新生儿听力筛查技术规范"纳入<新生儿疾病筛查技术规范>以来,全国多数省已经制定了新生儿听力筛查的相关法规和管理办法,并举办过相关的培训班,使该项工作得到了较为广泛的开展.     

上海市新生儿听力筛查工作

上海市从2002年开展新生儿普遍听力筛查以来,4年间已构建了较为完整的新生儿听力筛查干预体系,本文对上海近几年实施新生儿听力筛查的宏观管理及实施效果进行回顾。1上海市新生儿普遍听力筛查的宏观管理1.1组织管理。上海市卫生行政部门负责进行宏观管理,协调有关部门制定相应政策,审定任务目标,制定工作计划和经费预算,组织考核验收。具体负责构建新生儿听力筛查网络,充分利用各地区已形成网络的基层妇幼保健单位,构建新生儿听力筛查网络;对新生儿听力筛查机构和人员进行审批;制订新生儿听力筛查技术规范;对新生儿听力筛查实施全面质量管理…     

Titan听力测试平台在新生儿听力筛查及听力诊断中的应用

目的应用Titan对初筛未通过的听力高危新生儿进行复筛,评价Titan在新生儿听力筛查及听力诊断中的作用。方法对223例（446耳）初筛未通过的听力高危新生儿在出生后第40天左右（前后不超过3 d）应用Titan分别行自动听性脑干反应（automated auditory brainstem response, AABR）、耳声发射（otoacoustic emission,OAE）、声导抗检测;AABR、OAE系统自动判断是否通过,声导抗检测采用1 KHz探测音,鼓室压低于-50 dapa、声顺＜0.3 ml认定为异常;统计数据,并分析其结果。结果AABR复筛通过436耳,复筛通过率为97.76%（436/446）,OAE复筛通过348耳,通过率为78.03%（348/446）,二者差异有显著性（χ2=81.59,P<0.05）;声导抗检测异常者共81耳,异常率为18.16%（81/446）,其中在AABR复筛未通过10耳中存在声导抗检测异常者共1耳,异常率为10%（1/10）,OAE复筛未通过98耳中存在声导抗检测异常者共57耳,异常率为58.16%（57/98）,二者差异有显著性（χ2=6.64,P<0.05）。结论Titan是一款集AABR、OAE、声导抗检测于一体的新型听力检测仪器,应用于新生儿听力筛查可有效降低假阳性率,并能及早评价患儿的中耳功能,鼓室负压、咽鼓管功能不良是新生儿听力筛查假阳性率高的一个重要因素。     

The effectiveness of the promotion of newborn hearing screening in Taiwan

Objective

Hearing is a critical ability for the development of a child's speech and language. Many studies in different countries have shown the universal newborn hearing screening and early intervention has greatly reduced the negative impact caused by congenital hearing loss. The first universal newborn hearing screening program in Taiwan took place in MacKay Memorial Hospital in 1998 and was subsequently endorsed by the government. The incidence of bilateral congenital hearing impairment in Taiwan is approximately 2.6 per 1000 live birth. The aim of this paper is to analyze the age of diagnosis, hearing aid fitting, and intervention of congenitally hearing impaired children with and without hearing screening after public awareness and government endorsement of newborn hearing screening.

Materials and methods

There were 263 hearing impaired children participated in this study, receiving their auditory habilitation therapy at Children's Hearing Foundation from 2006 to 2010. 114 of those children went through newborn hearing screening and 149 without it. The age of diagnosis, hearing aid fitting, and auditory intervention were compared between these two groups. The age of diagnosis and intervention of congenitally hearing impaired children among different years were analyzed too.

Results

The average age of diagnosis was 8.7 months, the age of hearing aid fitting was 12.4 months and age of auditory intervention was 18.8 months for the group of hearing impaired children with newborn hearing screening. For hearing impaired children without newborn screening, their average age of diagnosis was 27.5 months; age of hearing aid fitting was 31.3 months and age of auditory intervention was 40.5 months. There were significant differences in the age of diagnosis, hearing aid fitting and auditory intervention between congenitally hearing impaired children with and without hearing screening.

Conclusions

This research indicates that newborn hearing screening facilitates early identification, diagnosis and intervention of congenitally hearing impaired children in Taiwan. The age of identification, diagnosis and intervention of congenital hearing impaired children has also been reduced gradually over the years after government endorsement of newborn hearing screening in Taiwan.     

耳声发射应用于新生儿听力筛选的研究

目的 研究瞬态诱发耳声发射（ｔｒａｎｓｉｅｎｔ ｅｖｏｋｅｄ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｉｓｓｉｏｎｓ，ＴＥＯＡＥ）产畸变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎ ｐｒｏｄｕｃｔ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｉｓｓｉｏｎｓ，ＤＰＯＡＥ）应用于新生儿听力筛选的可行性，控诉听力筛选的标准。方法 应用Ｃｅｌｅｓｔａ５０３型耳声发射分析仪对１０８名新生儿（２１６耳）进行ＴＥＯＡＥ和ＤＰＯＡＥ听力筛选，与听性脑     

先天性外中耳畸形患者生活质量量表的编制与检验

目的 编制一个评价先天性外中耳畸形患者生活质量的多维测评量表,并对该量表进行信度和效度分析.方法 参考国内外生活质量量表,构成患者生活质量初始量表,对140例先天性外中耳畸形患者进行生活质量的预测试后,进行条目筛选,建立量表,并对量表作信度和效度检验.结果 编制的先天性外中耳畸形患者生活质量量表(简称量表)包含生理功能、心理状态、社会关系等三个维度,18项条目.量表的重测信度为0.878,分半信度为0.927,克朗巴赫α系数为0.899;经因子分析获得的因子结构与量表设计的预想结构一致,具有较好的结构效度.量表的信度和效度符合心理测量学要求.结论 本研究量表是可信、有效和敏感的,可应用于临床评估.     

Development and validation of the effectiveness of [corrected] auditory rehabilitation scale

OBJECTIVE: To develop a new scale of hearing-related function and quality of life in patients with hearing aids that addresses overlooked concerns, such as hearing-aid comfort, convenience, and cosmetic appearance, that may influence hearing-aid adherence while maintaining brevity and sensitivity to clinical change. DESIGN: Prospective, multicenter instrument validation. SETTING: Four diverse sites in Washington State, including 2 private practices, 1 university setting, and 1 Veterans Affairs hospital. PATIENTS: Seventy-eight patients with hearing aids. INTERVENTIONS: We created 2 modules in the Effectiveness of Auditory Rehabilitation (EAR) scale. The first module (Inner EAR) covers intrinsic hearing issues such as hearing in quiet and hearing in noise and is administered both before and after treatment. The second module (Outer EAR) covers extrinsic (hearing-aid related) issues such as comfort, appearance, and convenience and is administered after hearing-aid fitting. MAIN OUTCOME MEASURES: Both scales were developed and validated in 3 stages. Stage 1 used a qualitative approach from multiple data sources to develop preliminary instruments. Stage 2 used approaches from classic test theory to reduce the number of items and psychometrically validate the instruments. Stage 3 examined the responsiveness or sensitivity to clinical change. RESULTS: A 10-item Inner EAR module and a 10-item Outer EAR module were created and validated. Internal consistency of individual domains (Cronbach alpha = 0.85 and 0.72, respectively) and test-retest reliability (intraclass correlation coefficients = 0.76 and 0.81, respectively) were excellent. Evidence of construct validity included concurrent validity with other hearing scales and global visual analog scales, discriminant validity with dizziness handicap, correlation with hearing-aid adherence, and confirmatory factor analyses. Both scales had strong evidence of responsiveness (sensitivity to change), with higher effect sizes and Guyatt responsiveness statistics than the 2 widely used hearing scales in this study. The scales took an average of 5 minutes to complete. CONCLUSIONS: The EAR scale is a valid and reliable measure of the effectiveness of amplification in the treatment of sensorineural hearing loss. It addresses the range of issues that are of importance to hearing-aid patients. The scales have excellent psychometric properties, are more responsive than several widely used hearing scales, and are minimally burdensome for patients to complete. The EAR may be a valuable outcome measure in future studies of both existing hearing aids and newer hearing-aid technologies, such as bone-anchored aids or middle ear implants.     

Overview of newborn hearing screening programs in Brazilian maternity hospitals

IntroductionNewborn hearing screening has as its main objective the early identification of hearing loss in newborns and infants. In order to guarantee good results, quality indicators for newborn hearing screening programs are used as benchmarks.ObjectiveTo observe and describe the reality of national newborn hearing screening programs in Brazil, and to evaluate if they can be referred to as having quality indicators.MethodsIntegrative literature review in databases such as MEDLINE, LILACS, SciELO, and Google.Results22 articles were analyzed in relation to newborn hearing screening coverage, the place and period newborn hearing screening was performed, initial results, referral to diagnostic procedures, loss to follow-up, and occurrence of hearing loss.ConclusionTransient otoacoustic emissions were the most often used screening methodology. Coverage varied widely, and only a few maternity wards achieved 95% of the cases screened. Referral to diagnostic procedures was under 4%, but lack of adherence can be considered a barrier to successful follow-up. The occurrence of hearing loss ranged from 0% to 1.09%. The involvement of government, physicians, and society is necessary, so that the goals of newborn hearing screening can be achieved.     

Predictive validity and reliability of adult hearing screening techniques

The purpose of this study was to evaluate and compare the efficacy of hearing screening tools to identify hearing loss in the older adult population. The test-retest reliability of both the AuDX DPOAE hand-held screener and subjective otoscopic ratings of percent earwax accumulation were evaluated. Additionally, the predictive validity was investigated for five hearing screening tools: the DPOAE hand-held screener, pure-tone screening, screening otoscopy, self-assessment of communication, and case history screening. The research was conducted through typical community hearing screenings on normal-hearing and hearing-impaired volunteer subjects. The screening subjects included 67 adults aged 49 to 89 years. Of those, 44 returned for a full audiologic evaluation. Key findings include: (1) Pure-tone screening had predictive validity for actual hearing loss in the older adult population when a 25 dB HL fence is used; (2) Screening otoscopy ratings were highly reliable across time and raters; (3) Self-assessment scores did not predict compliance with referral recommendations; (4)The AuDX DPOAE hand-held screener proved to be reliable in the overall pass/refer outcome, but lacked predictive validity for actual hearing loss in older adults.     

新生儿听力筛查的研究历史与现状

听力损失会影响儿童言语语言发育、心理发育、教育、就业和婚育,而且会影响家庭沟通、给家庭带来经济压力,给社会带来沉重负担。许多国家联系已有的保障、社会和教育系统,使用各种筛查方法和方案已成功地开展了早期听力检测和干预项目,认识到了新生儿听力筛查的重要性,并积极加强与国际的交流与合作,进行新生儿听力筛查项目的培训和实施。早期发现、早期诊断、早期治疗,旨在提高生活水平,提高人口素质,使新生儿听力筛查项目在曲折中不断向前发展。本文从新生儿概况、新生儿听力筛查的发展阶段、筛查技术以及面临的挑战回顾了新生儿听力筛查的发展现状,并提出展望。     

抚触护理应用在新生儿听力筛查中的效果及价值研究

目的探析新生儿听力筛查中采取抚触护理的临床效果及价值。方法选取2018年7月~2020年9月于本院实施听力筛查新生儿,统计90例,按双盲法原则分组,即对照组(n=45)和观察组(n=45),对照组于听力筛查中行常规护理,观察组加用抚触护理,比较两组效果。结果观察组听力筛查成功率及测试状态优良率相比于对照组明显升高(P<0.05)。结论新生儿听力筛查中采取抚触护理效果令人满意,可进行听力筛查成功率的明显提高,优化听力筛查质量,应用可行性强,具临床运用价值。