听力筛查未通过的婴儿听力追踪检查

目的：探讨听力筛查未通过的婴幼儿的听力变化及其特点。方法：对使用ABR、DPOAE、声导抗而未通过听力筛查的新生儿分别在3月龄及6月龄时行客观听力检查，将2次检查结果进行比较和分析。结果：DPOAE在3月龄时测试假阳性率为9．6％；6月龄的复查和3月龄的初查相比较，重度或极重度听力损失者听力基本无改变，而轻-中度听力损失者转化为正常或听力改善所占的比例较高；将3月龄和6月龄2次ABR检查所得的ABR阈值，分左、右耳侧，前、后比较，左侧t=3．496，P〈0．01，右侧t=5．572，P〈0．01，差异有统计学意义。结论：未通过DPOAE筛查者不能立即作出听力损伤的结论，必须与ABR检查相互结合，相互补充；重度以上的听力损失者3月龄的早期诊断和6月龄的早期干预是可行的，而轻-中度听力损失者应进行至少2次以上的听力检测和6个月以上的追踪，并根据听觉行为测试和日常生活观察综合分析各项检查结果后才可得出正确诊断。

Follow-up examination for newborns and infants who failed hearing screening

Objective:To investigate the hearing change and the characteristic of hearing thresholds of the infants failing in the hearing screening.Method:ABR,DPOAE and acoustic immittance were used to test infants failing in the screening in their third month and the sixth month,whose results were compared.Result:In the third month the false postive rate of DPOAE test was 9.6% . Comparing with the results tested in the third month, the degree of severe hearing loss retested in the sixth month did not change much. But the percentage of the slight-moderate hearing loss improvement to normal or better was higher.Comparing ABR threshold result in the third month and that in the sixth month,t=3.496, P<0.01 in the left ear, and t=5.572, P<0.01 in the right ear,respectively. There was significant difference between these results.Conclusion:The new-borns failing DPOAE can not be just considered to indentifying hearing loss,and it must be with the ABR to make the diagnosis. It is feasible to diagnose severe-profound hearing loss in the third month and interfere before the sixth month,but the infants with mild-moderate hearing loss must undertake the auditory tests more than twice and be followed up in more than half a year, then we can make dignosis according to the audiologic evaluations results and the daily behaviors.