听力计检测作为新生儿听力筛查方法的评价

婴幼儿期是诊断听力障碍的关键期,本研究旨在寻找经济、简便而可靠的婴儿听力筛查方法.方法 采用整群抽样方法,以 2378例新生儿作为研究对象.以听觉脑干诱发电位仪(ABR)为诊断仪器,比较评价便携式听力计(听力计)、塑料盒、小鼓和金属钤4种方法.对象同时接受4种方法听力筛查,比较各法所需时间和费用.其中275例进行了ABR诊断测试,并以此为标准,计算各法的灵敏度和特异度,及与 ABR的相关性.结果 听力计的灵敏度最高(62.5%),塑料盒和金属铃次之,约37.5%,小鼓最低,仅25.0%.4法的特异度均较高,为85.7%～93.2%.与ABR的相关程度,也以听力计为高,塑料盒、鼓和铃逐减,前两者相关具显著性.ABR操作时间及费用最多,听力计其次.结论如无新方法出现时,便携式听力计,为目前国内首选的新生儿听力行为观察筛查方法.其他几种方法稍逊.

Assessment of the Pediatric Audiometer Approach as a Neonatal Hearing Screening Test

This study was designed to identify a screening method of neonatal behavioral audiometers which should be fast, easy, reliable and low-cost. Methods Four behavioral observation tools were used in this study; pediatric andiometer, model PA2, plastic box, small drum and metal bell. The hearing capability of 2 378 neonates were tested, in which 275 randomly sampled cases were examined with Auditory Brainstem Response (ABR). The specificity and sensitivity of the four testing methods were calculated with the assessment method of epidemiological screening program. The results of ABR analysis was regarded as diagnostic criteria. We assess and analyze the four methods to learn if these methods can be used as a method of newborn hearing screening test. Results The results show that the pediatric audiometer has the following distinguishing features:(1) the cost is bearable. (2)the equipment is simple and ease to operate, the examination is fast, (3)the sensitivity is the highest among the several methods now available and the specificity is higher than other methods. Conclusions The pediatric audiometer is the first choice in various neonatal behavioral audiometers at the present, while new method is still to be developed.