重症监护病房与母婴同室新生儿听力筛查比较

目的 探讨新生儿重症监护病房患儿听力筛查情况并与母婴同室新生儿听力筛查情况进行比较。方法 对927例新生儿重症监护病房患儿和16353例母婴同室新生儿采用瞬态诱发耳声发射进行初筛和复筛，并对筛查阳性者进行诊断性听力学检测。结果 927例新生儿重症监护病房患儿中，通过筛查发现感音神经性听力障碍28例，其中高胆红素血症11例，极低体重儿9例，缺血缺氧性脑病6例，脑膜炎2例，检出率为3.02%（28/927）；母婴同室听力筛查新生儿16353例中，发现感音神经性听力障碍50例，检出率为0.31%（50/16353），其中有宫内感染史23例，高胆红素血症12例，有耳聋家族史10例，脑膜炎病史3例，母亲孕期耳毒性药物使用史2例，二者差异有统计学意义（P＜0.05）。结论 新生儿重症监护病房患儿感音神经性听力障碍的检出率明显高于母婴同室新生儿；高胆红素血症、极低体重儿和缺氧缺血性脑病是新生儿重症监护病房患儿感音神经性听力障碍发生的主要高危因素；宫内感染、高胆红素血症及耳聋家族史是母婴同室新生儿感音神经性听力障碍发生的主要高危因素，应该强化对这部分新生儿听力筛查和干预工作。

Comparative study of newborn hearing screening between the neonatal intensive care unit and well-baby nursery

Objective To investigate the hearing screening situation of newborns in the neonatal intensive care unit (NICU) and compare it with that of newborns in the well-baby nursery. Methods Hearing screening was carried out in 927 newborns in the NICU and 16353 newborns in the well-baby nursery. All newborns were screened and re-screened with transient evoked otoacoustic emission. Positive cases were evaluated by a diagnostic audiology test. Results 28 cases of sensorineural deafness were founded in the NICU group, of which 11 had hyperbilirubinemias, 9 very low birth weight, 6 ischemic encephalopathy and 2 meningitis. The incidence rate of sensorineural deafness in the NICU group was 3.02% (28/927). There were 50 cases of sensorineural deafness in the well baby nursery group, of which 23 had intrauterine infection, 12 hyperbilirubinemias, 10 family history of hearing loss, 3 meningitis and 2 ototoxic drug contact history. The incidence rate of sensorineural deafness was 0.31% (50/16353). There was a significant difference between the two groups(P＜0.05). Conclusions The incidence rate of sensorineural deafness is obviously higher in the NICU group than the well baby nursery group. Hyperbilirubinemias, very low birth weight and ischemic encephalopathy are the main risk factors in the NICU group. Intrauterine infection, hyperbilirubinemias and family history of hearing loss are the main risk factors in the well-baby nursery group. More attention should be paid to newborn hearing screening in the NICU.