2399例新生儿听力筛查情况分析

目的:分析普通产房和新生儿重症监护室(neonatal intensive care unit,NICU)新生儿听力筛查结果,研究胎龄与初筛通过率的相关性。方法:对2010年6月至2011年11月共2 399例新生儿(普通产房新生儿945例,NICU病房新生儿1454例)做听力筛查,初筛为出生后1～5 d行耳声发射(oto-acoustic emission,OAE)检查,初筛未通过者出生后42 d内接受第2次OAE复筛。复筛未过者在3个月内行诊断性听觉诱发电位(auditory brainstem response,ABR)检查。结果:我院新生儿筛查率98.7%;初筛通过率82.33%,其中普通产房初筛通过率91.53%,NICU初筛通过率76.36%;初筛未通过者中复筛率86.08%,失访率13.92%;复筛通过率90.14%,其中普通产房复筛通过率89.70%,NICU新生儿复筛通过率90.02%,ABR确诊听力障碍者8例,听力障碍发生率3.3‰。初筛假阳性率17.3%,复筛假阳性率7.84%。NICU新生儿初筛通过率明显低于普通产房新生儿初筛通过率(P<0.05),普通产房和NICU复筛通过率比较差异无统计学意义(P>0.05)。初筛通过率随着胎龄的减少而降低(r=1)。结论:提高对NICU患儿听力复筛的重视,加强孕产期的处理足月生产,对早产儿纠正胎龄后筛查以提高筛查通过率。

Hearing screening in 2399 newborns

Objective:To study the initial screening passing rate of Ordinary ward and NICU,to analysis the pass rate of the initial screening which influenced by different gestational ages.Methods:We conducted screening for 2399 neonates in our hospital,among the test 945 neonates come from Ordinary ward,1454 neonates come from NICU.The initial screening by OAE was performed between postnatal 1~5 days.Neonates who failed initial screening were checked again by OAE on the postnatal day 42,those who still failed to pass the investigation underwent definitive hearing assessment by the third postnatal month by ABR.Results:The screening rate in our hospital was 98.7%.The initial screening passing rate was 82.33%,and the secondary screening was 86.08%,loss ratio was 13.92%.Secondary screening passing rate was 90.14%,8 persons are diagnosed hearing patients.The incidence of hearing loss was 3.3‰.False positive of the initial screening was 17.3%,false positive of the secondary screening was 7.84%.The initial screening passing rate of NICU was lower than that of the Ordinary ward.The initial screening passing rate of the new babies whose gestational age is less than 37 weeks was lower than that of the babies whose gestational age is more than 37 weeks.Conclusion:In order to improve the passing rate,we should pay more attention to the secondary screening and screening after correct gestational age.