重症监护病房新生儿听力筛查研究

【目的】 探讨重症监护病房(NICU)新生儿听力筛查模式及影响听力筛查的因素。【方法】 对NICU新生儿在病情稳定后及出生42d时常规用畸变产物耳声发射仪(DPOAE)进行听力初筛和复筛，初筛同时调查每个新生儿的出生史、家属史、母亲妊娠史、父母社会阶层等。复筛未通过者ABR检查，ABR检查异常者在6个月时再次复查ABR，经两次ABR检查异常者确诊为听力损失。所有资料均录入计算机，利用SPSS统计软件进行统计分析。【结果】 NICU新生儿287例，初次筛查通过223例，通过率77．7％；复筛227例，通过213例，通过率93．8％；3个月内ABR检查14例，通过11例，未通过3例在6个月时再次ABR检查，最后确诊听力损失2例，听力损失发病率7．0‰，其中1例初筛通过。初筛通过率右耳高于左耳，女婴高于男婴，足月儿高于早产儿，出生体重2500g以上者高于2500g以下者，单胎高于多胎，日龄小于6d者高于6d以上者。【结论】 全体NICU新生儿均应成为听力监测的对象，两次常规筛查是NICU合适的筛查模式。影响DPOAE筛查的因素有性别、孕周、出生体重、胎数，疾病严重程度。

Study of universal newborn hearing screening in neonatal intensive care unit

To seek the modle of newborn hearing screening in neonatal intensive care unit(NICU) and the factors affecting hearing screening. All 287 newborns received hearing screening test by distortion product otoacoustic emissions(DPOAE) after their disease stabilization and rescreened 42 days after their birth,and the effective factors were investingated such as: birth history, pregnancy history of mother, family history and social position of parent et al. Infants who failed to pass the rescreening test would received auditory brainstem response (ABR) test, the abnormal infants received ABR test again when they were in six month.All data were analysied by SPSS 10.0. 223 (77.7%, 223/287)newborns passed the DPOAE screening in the hospital, 227 infants received DPOAE rescreening test and 213 (93.8%,213/227) infants passed, 3 infants received ABR test failed to pass at their three month old, but one infant passed ABR test in their six month old, 2 infants had been confirmed hearing loss. The pass rate of first screening test was higher in right ears, female baby, term pregnancy, higher birth weight and monocyesis. [Conclusions] All newborns of NICU should receive the hearing screening, two routine hearing screening is a feasible modle. The factors such as sex, fetus age, birth weight, fetus number, severity of disease can affect the results of DPOAE.