新生儿及疑似听力障碍儿童听力筛查的病例分析

目的1.收取本地区新生儿听力障碍发病资料;2.分析听力筛查未通过的因素及临床听力学特征。方法选取2006年5月至2007年5月出生的286例新生儿,在出院前进行新生儿听力筛查;96例转诊至我科的疑似听力障碍患儿进行诊断性听力学检查。对未通过者进行声阻抗、耳声发射、听性脑干反应、听觉稳态诱发反应全面的综合检查以确定听力损失的性质和程度,给予相应干预措施。结果286例新生儿,其中初筛有40例（13.99%）未通过筛查,42天复筛DPOAE,最后有3例需行ABR检查,经过听力学初步评估发现2例（发病率为6.99‰）有听力损失,其中正常新生儿1例（发病率为3.94‰）,高危新生儿1例（发病率为31.25‰）并作相应诊断和干预;转诊疑似听力损失患儿96例,确认听力损失78例（81.25%）,其中轻度2例（2.5%）、中度7例（9.0%）、重度25例（32.1%）、极重度44例（56.4%）,发现确诊年龄在6个月～3岁范围内。结论3个月内早期诊断和6个月内早期干预是必要的,以便尽早发现患儿及时给予干预。推行新生儿及婴幼儿听力损失的早期筛查和干预,加强耳聋知识的宣传,提高家长的防聋治聋意识是非常必要的。

Newborns and children suspected of hearing loss in the preliminary hearing screening analysis

Objective： 1. To acquire the basic data of prevalence of newbom＇s heating loss in Harbin ; 2. To analyze the confusing factors and clinical and audiological characteristics in infants failed in hearing screening. Methods： 286 newborn born at Heilongjiang Province Hospital of Harbin. Form May 2006 to May 2007, and 96 babies who had risk factors of hearing loss received the audiometry . Those infants who failed the audiometry had to receive comprehensive examinations such as acoustic impedance audiometry （AIA）, otoacoustie emission （OAE）, auditory brainstem response （ABR） and auditory steady -state response （ASSR）. Resuits： 40 cases （13.99%） who failed the first audiometry received the second audiometry 286 newborns . In 40 cases of the second screening, 3 cases received ABR test while 2 cases （6. 99%0） showed hearing loss , 1 cases （31.25‰） was found at high risk while the other one （ 3. 94‰） was normal newborn. Among 96 infants who were unclearly diagnosed to have hearing loss, 78 cases （81.25%） had heating loss, with 2mild cases （2. 5% ） , 7moderat is cases （9.0%） , 25severe cases （32. 1% ） and 44 extremely severe cases （56.4%）. Conclusion： 3 months early diagnosis and 6 months early intervention is necessary , found that children as early as possible in order to give a timely intervention. It is also necessary to popularize newborn hearing screening and early intervention while to enhance the parents＇ consciousness.