未通过听力筛查的新生儿听力追踪分析

目的探讨未通过听力筛查的婴幼儿听力变化及特点。方法调查我院妇产科2004年9月～2006年9月出生的7808例新生儿采用畸变产物耳声发射法（DPOAE）进行听力筛查，未通过102例转广州市儿童医院耳鼻喉科行脑干诱发电位检查（ABR），以了解新生儿听力障碍的情况并对听力障碍儿童结果进行分析评估和确认。结果102例婴幼儿最后确认听力正常78例占76．47％，听力损失24例占23．53％，24例最后经ABR确诊听力轻度障碍12例（11．77％），中度障碍6例（5.88％），重度4例（3．92％），极重度2例（1．96％）。本组资料提示，各种听力损失（包括单耳和双耳）的患病率为0．307％（24／7808）。从初诊到最后确认，重度和极重度以上听力损失者的听力基本无改变，而轻度、中度听力损失者的听力有改善的正常趋势。结论重度以上听力损失者，3个月内的早期诊断和6个月内的早期干预是可行的；轻～中度听力损失者应进行至少二次以上听力检测、至少6个月以上的跟踪随访，综合分析各项检查结果后才能做出正确诊断。

A trace analysis of hearing of screening-failure infants

Objective To investigate the hearing changes and characteristics of the hearing screening-failure infants.Methods Hearing of 7808 cases of newborn infants in our hospital born from September 2004 to September 2006 were screened with DPOAE.The 102 cases who failed to pass the screening were transferred to Guangzhou Children's Hospital where ABR was conducted on them to understand reasons of their hearing disturbance and analyze the results.Results Among the 102 newborns 78 cases were finally confirmed as normal in hearing(76.47%)and 24 as hearing loss(23.53%).Of the other 24 cases,ABR identified 12 cases as light hearing disturbance(11.77%),6 cases as moderate(5.88%),and 4 cases as severe(3.92%)and 2 cases as extremely severe(1.96%).Data from this group suggested the morbidity of various stages of hearing loss(including unilateral and bilateral ears)was 0.307%(24 /7808).Starting from the initial diagnosis to final identification,the infants suffering from severe and extremely severe hearing loss showed no improvement in hearing while whose with light and moderate hearing loss demonstrated the tendency for better.Conclusion For severe hearing loss cases,early diagnosis within 3 months and early treatment within 6 months is feasible.In the case of light and moderate hearing loss,hearing should be checked at least twice and followed up no less than 6 months.Comprehensive analysis of examination results is necessary before correct diagnosis is obtained.