新生儿听力复筛未通过的婴幼儿听力随访及干预情况

Follow-up and Intervention for Failed Infants and Young Children in Hearing Re-screening Programs

目的探讨新生儿听力复筛未通过婴幼儿的听力随访及干预情况。方法对200例(400耳)新生儿听力复筛未通过的婴幼儿使用耳声发射(OAE)、声导抗、听性脑干反应(ABR)测试进行听力学初诊及复诊,观察患儿的听力变化,了解其干预情况。结果200例(400耳)婴幼儿,初诊听力正常61例(30.50%,61/200),139例(69.50%,139/200)有单耳或双耳听力损失,其中,轻度87例(62.59%,87/139),中度22例(15.83%,22/139),重度9例(6.47%,9/139),极重度21例(15.11%,21/139)。139例听力损失患儿接受复诊91例(65.47%,91/139),失访48例(34.53%,48/139),复诊听力正常57例,听力损失34例,其中,轻度5例,中度4例,重度6例,极重度19例,极重度听力损失者中有6例合并脑部发育异常(脑瘫3例、脑损伤综合症3例)。34例听力损失患儿中接受干预24例,其中轻度2例(40%,2/5)、中度2例(50%,2/4)、重度3例(50.0%,3/6)、极重度17例(89.47%,17/19)。合并有脑部发育异常的患儿同时进行综合性康复。结论本组新生儿听力复筛未通过婴幼儿中,中度以上听力障碍的患儿随访及干预接受率较高,中度以下的听力障碍患儿随访及干预接受率较低;重度以上感音神经性听力障碍患儿尤其是伴有听力障碍高危因素的婴幼儿的听力无明显变化。

Objective To analyze the outcome of the follow-up and intervention for infants and young children who failed in hearing re-screening.Methods Auditory diagnosis consisting of OAE,tympanometry and ABR were adminstered to 200（400 ears） infants and young children who failed in the hearing re-screening.The tests results were recorded during the follow-up and interventions.Results Among 200（400 ears） infants and young children,61 cases were normal and 139 cases had a hearing loss in one ear or both ears.Out of 139 cases with hearing loss,87 were mild,22 moderate,9 severe and 21 profound.Among 139 with hearing impairment,48 cases failed to show up in the follow ups,among whom 39 were mild,6 moderate,2 severe and 1 profound.Among 91 follow ups 34 cases were confirmed with hearing impairment.5 were mild,4 moderate,6 severe and 19 profound.For those with profound hearing loss,3 suffered from cerebral palsy and 3 had brain injury.24 cases received intenvention：5 mild,4 moderate,6 severe and 19 profound.Combined treatments were also delivered to the patient with abnormal brain development.Conclusion Infants and young children who failed in hearing re-screening and those with moderate or more severe hearing impairment were more inclined to receive follow-up and interventions compared to others with less severe hearing impairment.Most have profound or severe sensorineural hearing loss in children with no significant change in hearing,especially for those infants and young children at high risks.