山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (2): 8-12.doi: 10.6040/j.issn.1673-3770.0.2012.297

• 论著 • 上一篇    下一篇

新生儿听力筛查11894例结果分析

刘志奇1，2，刘立思1，杨琨3   

  1. 1.华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科， 武汉 430030；
    2.湖北省妇幼保健院耳鼻咽喉科， 武汉 430070；
    3.武汉大学人民医院耳鼻咽喉头颈外科， 武汉 430060
  • 收稿日期:2012-10-04 发布日期:2013-04-16
  • 通讯作者: 刘立思。 Email：profliu@hotmail.com
  • 作者简介:刘志奇，博士。 Email：liuwu188@tom.com

Hearing screenings  in 11894 infants

 LIU Zhi-qi1，2， LIU Li-si1， YANG Kun3   

  1. 1. Department of OtolaryngologyHead and Neck Surgery, Tongji Hospital， Tongji Medical College Huazhong University of Science and Technology, Wuhan 430030, China； 2. Department of Otorhinolaryngology of Hubei Provincial Women and Children’s Hospital, Wuhan 430070, China； 3. Department of OtolaryngologyHead and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
  • Received:2012-10-04 Published:2013-04-16

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摘要：

目的   了解新生儿听力筛查的通过率、听力损失的发病率,分析可能导致新生儿听力损失的原因。方法   瞬态诱发性耳声发射(TEOAE)按两阶段方案进行听力筛查, 11894例新生儿中未通过者3月龄后行畸变产物耳声发射(DPOAE)、1000Hz探测音鼓室导抗、听性脑干反应(ABR)测试,结果用统计学软件SPSS15.0分析。结果   初筛通过率为82.64%，复筛通过率为78.71%。产科病区新生儿初筛通过率为84.63%，新生儿重症监护病房(NICU)新生儿初筛通过率为78.00%，经比较两者差异有统计学意义(ANOVA，P<0.05)。确诊有听力损失患者68例(106耳),发病率约为0.57%，其中传导性听力损失31例，感音神经性听力损失16例，混合性听力下降21例。听力筛查双耳未通过组和单耳未通过组听力损失的患病率分别为12.92%(38/294)、5.00%(30/600)，中度及中度以上听力损失的比例分别为3.33%(1/30)、18.42%(14/76)，经比较差异有统计学意义(ANOVA，P<0.05)。引起听力损失的可能原因有：黄疸(24.56%，14/57)，感染(24.56%，14/57)，窒息(19.30%，11/57)，低体质量(17.54%，10/57)，其他因素(14.04%，8/57)。结论   听力筛查是早期发现新生儿听力损失的基础性工程；双耳听力筛查未通过比单耳听力筛查未通过患儿存在听力损失的可能性更大，听力损失的程度也可能更重；黄疸、感染、窒息和新生儿低体质量是导致听力损失的常见原因。

关键词: 听力筛查；耳声发射；听性脑干反应；鼓室导抗测试；体层摄影术, Ｘ线计算机；新生儿

Abstract:

Objective    To obtain the pass rate of hearing screening, the incidence and cause of hearing loss in the newborns. Methods   11894 cases were screened by a two-stage program of transient evoked oto-acoustic emissions test(TEOAE). The failed were re-examined with DPOAE,1000Hz probe tone tympanometry, auditory brainstem response(ABR) 3 months later. The results were analyzed. Results  The primary screening pass rate was  82.64%, while the secondary pass rate was 78.71%. The pass rates were 84.63% and 78.00% in the obstetric ward and NICU ward,respectively (ANOVA, P<0.05). 68 cases (including 106 ears) were diagnosed as hearing loss with the incidence rate at 0.57%. Among them, there were 31 conductive hearing loss, 16 sensorineural hearing loss, and 21 mixed hearing loss. In the groups with the tests failed bilaterally or unilaterally , the corresponding prevalence rate was 12.92% (38/294) or 5.00% (30/600). The proportions of moderate and severe hearing were 3.33% (1/30) and 18.42% (14/76) (ANOVA, P<0.05). The possible causes of hearing loss consisted of jaundice (24.56%, 14/57), infection (24.56%, 14/57), asphyxia (19.30%, 11/57), low birth weight (17.54%, 10/57), and other factors (14.04%, 8/57). Conclusion   Hearing screening is a basic project for early detection of neonatal hearing loss. Binaurally failed cases are more likely to develop into hearing loss than the unilateral, and the degree of hearing loss might also be more severe. Jaundice, infection, asphyxia, and low birth weight are major causes for neonatal hearing loss.

Key words: Hearing screening, Auditory brainstem response, Computerized tomography, CT； Infant, Tympanometry, Otoacoustic emission

中图分类号: 

  • R764.5
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