耳声发射在新生儿重症监护病房的应用研究

Otoacoustic Emissions in Neonatal Intensive Care Unit for Hearing Screening

目的探讨应用畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)技术在新生儿重症监护室(neonatal intesive care unit,NICU)进行听力筛查的敏感性和假阴性。方法应用GSI70全自动畸变产物耳声发射仪对本院新生儿重症监护病房的116名婴儿在住院期间进行听力筛查,与听性脑干反应(auditory brainstem response,ABR)测试结果进行对照。结果在116例(232耳)患儿中,DPOAE和ABR测试结果的共同阳性率分别为42.19%,共同阴性率分别为93.45%,DPOAE测试中的假阴性率为57.81%,假阳性率为6.55%。结论在NICU中,应用DPOAE进行听力筛查具有较高的假阴性,会造成耳蜗功能正常的中枢性听损伤漏诊,ABR测试为比较可靠的新生儿听力筛查方法,用于NICU婴儿进行初筛更具有特殊意义。

Objective To evaluate the effectiveness of distortion product otoacoustic emissions for hearing screening in neonatal intensive care unit . Methods 116 infants （232 ears） were screened by DPOAE with GSI70 Automatic OAE . The outcome of DPOAE screening was compared with that of auditory brainstem response（ABR） test . Results Of 116（232ears） newborns , the co-positivity and co-negativity of DPOAE and ABR were42. 19% （27/64ears） and 93.45%（157/168. The false negativity and false positivity of DPOAE were57.81% （37 /64ears） and6.55%（11/168ears）. Conclusion In NICU , DPOAE screening made a high false negativity that may lead the central hearing loss missed , while ABR test has an important significance in first hearing screening for infants of NICU as a reliable method.