新生儿听力筛查及影响因素分析

目的 探讨引起新生儿听力损伤的危险因素,明确最适合高危新生儿听力筛查的方法及应对高危新生儿进行听力跟踪随访并进行及时干预的可行性.方法 使用瞬态诱发耳声发射(TEOAE)及自动听性脑干反应(AABR),对我院新生儿重症监护病房(NICU)中128例高危新生儿及产科病房中150例正常新生儿进行听力检测.结果 128例高危新生儿,TEOAE法通过率64.8％ (166/256),AABR法通过率71.1％ (182/256),150例正常新生儿,TEOAE法通过率96.3％ (289/300),高危新生儿筛查结果与正常新生儿比较差异有统计学意义(P＜0.05).结论 NICU中高危新生儿的听力筛查通过率明显低于正常新生儿,是听力障碍的高发人群;TEOAE法与AABR法在新生儿听力筛查中均存在一定的局限性,易漏诊或误诊部分听力障碍儿童,因此应将两种方法联合应用于高危新生儿听力筛查.

Newborn hearing screening and analysis of influencing factors

Objective To explore the risk factors which cause hearing impairment in newborn,the most suitable method of high-risk newborn hearing screening will be discussed and the feasibility of tracking high-risk neonatal follow-up hearing and giving timely intervention will be investigated. Methods Transient evoked otoaeoustic emissions （TEOAE） and automatic auditory brainstem response（AABR） were used to detect newborn hearing,through hearing test of the high-risk newborns in neonatal intensive care unit（NICU） and the normal newborn in maternity wards in our hospital. Results 128 cases of high-risk neonates were screened with TEOAE test, pass rate was 64.8% （166/256）, 150 cases of normal newborns were screened with TEOAE test, pass rate 96.3~ （289/300）. Comparing high-risk neonates with normal newborn,the screening results had significant differences in each group（ P d0.05）. Conclusion The hearing screening pass rate of the high-risk newborns in NICU is far lower than that of normal newborns, high-risk newborn hearing screening should be routinely carried out. There are some limitations both in TEOAE and in AABR, easily missed or misdiagnosed part of the hearing-impaired children. So,TEOAE and AABR methods should be applied to high-risk neonatal hearing screening jointly.