864例新生儿听力筛查结果分析

目的 通过新生儿听力筛查,初步了解先天性听力障碍发病的相关高危因素,为新生儿期、婴幼儿期保健及早期干预治疗提供依据.方法 对西安市兵器工业521医院2014年1月至2015年6月出生的864例新生儿采用瞬态诱发性耳声发射(TEOAE)进行听力筛查,初筛于生后2~7d完成,初筛未通过者于生后42d复筛,复筛未通过者于出生后3个月行听性脑干反应、声导抗等检查,并对外耳道发育畸形患儿行颞骨CT检查.结果 在864例(1727耳)新生儿中,初筛通过785例,初筛通过率90.86%,初筛未通过79例(157耳),其中,75例(149耳)接受复筛,复筛率为94.90%,复筛通过71例(142耳),复筛未通过4例(7耳),复筛通过率95.30%,总通过率99.07%.最终4例确诊为不同程度的先天性听力缺失,确诊听力缺陷率0.46%.听力筛查结果与性别的差异无统计学意义(χ2=0.43,P=0.5),与分娩方式的差异无统计学意义(χ2=2.55,P=0.1),与高危因素的差异有统计学意义(χ2=7.72,P=0.005).结论 在母婴同室与新生儿病区顺利开展听力筛查,对及早发现听力缺陷、加强高危儿的监测工作,具有非常重要的意义.

Analysis of hearing screening results of 864 neonates

Objective To understand the high-risk factors related with congenital hearing impairment through neonatal hearing screening and to provide some evidence for health care and early intervention at neonatal and infant period.Methods From January 2014 to June 2015,864 neonates born in 521 Hospital in Xi'an received hearing primary screening 2-7 days after birth by transient evoked otoacoustic emissions(TEOAE).Re-screening was performed 42 days after birth for cases who failed the primary screening.Those cases who failed again received further auditory brainstem response and acoustic immittance 3 months after birth, and cases with deformity of external auditory canal received CT examination.Results Among 864 cases(1 727 ears)screened,785 (90.86%)passed the primary screening,and 79 cases(157 ears)(9.14%)failed including 75 cases(149 ears)received re-screening with a re-screening rate of 94.9%.There were 71 cases(142 ears)passing re-screening test and 4 cases(7 ears)failed, and the pass rate of re-screening was 95.30%.The total pass rate was 99.07%.Four cases were confirmed with congenital hearing loss of different severity,and confirmed hearing defect rate was 0.46%.There was no statistical significance between hearing screening results and gender(χ2= 0.43,P= 0.5)as well as between those and delivery mode(χ2= 2.55,P= 0.1).But the difference in high-risk factors was significant(χ2= 7.72,P= 0.005).Conclusion Hearing screening carried out in NICU and neonatal ward is of great importance for early detection of hearing impairment and monitoring high-risk neonates.