重症监护室新生儿听力筛查结果分析

Analysis of Newborn Hearing Screening in Neonatal Intensive Care Unit

目的分析新生儿重症监护室(NICU)新生儿听力筛查结果,探讨影响新生儿听力的危险因素。方法对NICU 586例新生儿[其中新生儿窒息85例,早产儿216例,新生儿肺炎80例,新生儿高胆红素血症82例,足月小样儿64例,新生儿呼吸窘迫综合征(NRDS)59例]及同期产科出生的1 583例正常新生儿行瞬态诱发耳声发射(TEOAE)检查,同时登记新生儿的出生史等资料,采用χ2检验进行听力筛查通过率的比较,采用多因素非条件Logistic回归进行危险因素分析。结果 NICU新生儿,听力筛查通过451例,通过率76.96%;同期正常新生儿,听力筛查通过1 411例,通过率89.13%,两者通过率比较差异有统计学意义(P<0.01)。新生儿窒息组、早产儿组、新生儿肺炎组、新生儿高胆红素血症组、足月小样儿组、NRDS组通过率分别为80.00%、74.54%、71.25%、89.02%、84.37%、64.41%,早产儿组、新生儿肺炎组、NRDS组的通过率明显低于正常新生儿组,差异有统计学意义(均P<0.005);新生儿窒息组、高胆红素血症组、足月小样儿组的通过率与正常新生儿的通过率差异无统计学意义(均P>0.005)。多因素非条件Logistic回归分析显示胎龄、Apgar评分、肺炎、NRDS与听力筛查结果有相关性,是新生儿听力损伤的危险因素。结论 NICU新生儿听力筛查通过率较正常新生儿低,是听力损伤的高危人群;影响新生儿听力的因素有胎龄、Apgar评分、肺炎、NRDS,NICU新生儿最终的听力情况,常常是多个因素作用的结果;采取有效的早期干预措施,可以降低新生儿听力损伤。

Objective To analyze the results of newborn hearing screening in neonatal intensive care unit（NICU） and to investigate the risk factors affecting hearing screening.Methods Five hundred and eighty-six newborns in NICU [Including 85 newborns with asphyxia,261 premature infants,80 newborns with pneumonia,82 new borns with high bilirinbin,64 small for full term infants and 59 newborns with neonatal respiratory distress syndrome（NRDS）]and 1583 normal newborns in maternity unit received hearing screening test by transient evoked otoacoustic emission（TEOAE） and the effective factors,such as birth history,were investigated.Chi-square test and logistic regression was used to analyze the differences of passed rate and the risk-factors,respectively.Results Of the newborns in NICU,451 passed the TEOAE screening and the passed rate was 76.96%.Of the normal newborns,1 411 passed the TEOAE screening and the passed rate was 89.13%,which was significantly different from the newborns in NICU（P〈0.01）.The passed rate of newborns with asphyxia,premature infants,newborns with pneumonia,newborns with hyperbilirubinemia,small for full term infants and newborns with neonatal respiratory distress syndrome（NRDS） was 80.00%,74.54%,71.25%,89.02%,84.37% and 64.41%,respectively.Compared with the normal newborns,the passed rate in premature infants,newborns with pneumonia and newborns with NRDS increased significantly（P〈0.005）,while there is no difference between newborns with asphyxia,newborns with high bilirinbin,small for full term infants and normal newborns（P〉0.005）.The multi-factors analysis showed that the factors such as gestational age,Apgar scores,pneumonia and NRDS were correlated with the hearing loss.ConclusionThe newborns in NICU are high-risk people for hearing loss.The newborn hearing is affected by many factors such as gestaional age,Apgar score,pneumonia and NRDS.The early effective interventions can reduce newborn hearing loss.