听力筛查异常婴儿听性脑干反应测试随访

Auditory brainstem response testing revisit of infants who failed the hearing screening

目的:对本地区听力筛查异常婴儿ABR测试结果进行分析并总结其特点。方法:对140例新生儿听力筛查异常者在3个月龄左右时进行第1次ABR测试,第1次ABR诊断异常者于6个月龄左右进行第2次ABR测试,并进行统计分析。结果:140例婴儿经第1次ABR诊断,65例正常(46.43%);75例有单耳或双耳听力障碍(53.57%),其中单耳17.14%,双耳36.43%,以轻度听力障碍为最多,占27.14%,极重度听力障碍亦不少见,占14.29%;男、女听力障碍的发病率差异无统计学意义(P>0.05),高危儿与非高危儿发生听力障碍例数经比较差异无统计学意义(P>0.05),重度以上听力损失例数高危儿与非高危儿比较差异有统计学意义(P<0.05)。第2次ABR复诊38例,正常8例,总正常率52.14%(73/140);16例轻度听力障碍中10例转为正常或好转、6例无变化或加重,3例中度听力障碍中1例好转、2例无变化,9例重度听力障碍中3例好转、3例无变化、3例加重,10例极重度听力障碍中9例无变化或加重,1例脑瘫儿极重度听力障碍转归为正常;非高危儿听力好转情况显著高于高危儿(P<0.05)。结论:应全面开展新生儿听力筛查,重点关注高危儿听力损失;重度以下听力障碍具有可变性,对脑瘫等特殊儿童听力情况评估应慎重;应尽快建立健全的追踪、随访和管理体系。

Objective： Analyze the ABR testing results of local infants who failed the hearing screening and summarize its characteristics. Method：Carry on the first ABR test to 140 infants who failed the newborns hearing screening when they are about 3-month age, the unusualities carry on the second ABR test at about 6-month age, and carry on the statistical analysis. Result： One hundred and forty infants with the first ABR diagnosis, 65 infants are normal, accounting for 46. 43%; 75 infants have single or binaural ear hearing disorder, accounting for 53.57%, single ear 17.14%, binaural ear 36. 430/00, of which mild hearing disorder takes most, accounting for 27.14~, the profound hearing loss is also not extremely rare, accounting for 14.29~; Between male and female hearing disorder disease incidence rate difference is not remarkable statistics significance（ P 〉0.05） ; Between the number of high risk in the hearing injury and non-high-risk after the comparison difference is not remarkable sta- tistical significance（ P 〉0.05） ; With the population of above severe loss in hearing high-risk has the remarkable statistical significance with the non-high-risk comparison difference （ P 〈0.05）. The second ABR subsequently visit 38 infants, 8 infants normal, total normal rate 52.14% （73/140）, 16 infants mild hearing disorder 10 infants transfer normal either the change for the better, 6 infants do not have the change or the aggravation, 3 infants moderate hearing disorder 1 infant changes for the better, 2 infants do not have the change, 9 infants severe hearing disorder 3 infants have the change for the better, 3 infants do not have the change, 3 infants aggravate, 10 infants profound hearing disorder 9 infants do not have the change or the aggravation extremely, 1 example brain pa- ralysis profoung hearing disorder extension converges normally extremely; The non-high-risk whose hearing chan ges for the better is obviously higher than high-risk （ P 〈 0.05）. Conclusion： Should develop newborns＇ hearing screening comprehensively with key attention to high-risk loss of hearing; The severe hearing disorder has the variability, and so on exceptional child hearing situation appraisal should be prudent to the brain paralysis; should establish perfect tracing, revisiting and manageing system as soon as possible.