荣成地区9756例新生儿听力筛查分析

Analysis of hearing screen in 9756 newborns

目的探讨新生儿听力障碍的发生情况及高危因素,以便早期干预治疗。方法选择出生的活产新生儿于出生后72h接受耳声发射(OAE)测试,所有接受初筛的婴儿在出生42d后,再次接受OAE检查,未通过者做听觉脑干诱发电位(ABR)检查。一耳不通过即为不通过,不通过者均经两次以上重复测试。结果 9756名新生儿中8487名(87.0%)初筛通过;1270名未通过,于出生42d后复查,1236例通过。OAE测试总的通过率为99.6%。11例接受ABR检查,诊断有不同程度听力损失,发生率为1.1%。进行诊断患儿34例,其中11例出现不同程度听力损伤,听力损伤的发生率为0.32%(11/34),其中轻度损伤1例(9%),中度损伤8例(63.3%),重度损伤3例(27.3%),正常听力损伤检出率0.189‰,高危组检出率1.03%,高危儿听力损伤的发生率1.33%,(11/825)明显高于正常新生儿,两者比较有显著性的差异(P<0.05〉,分析8例高危儿发现早产,窒息,高胆红素血症,出生缺陷等可能与听力损伤有关。结论对所有新生婴儿应常规进行新生儿听力筛查,加强宣教,增加复查率,早期发现,早期治疗。耳生发射仪联合自动听性脑干反应能提高高危儿听力损伤的诊断率。听力损伤的发生病因复杂,在高危因素患儿列为重点筛查对象的同时,对所有婴儿均进行必要的监测,以减少儿童永久性听力损伤的发生率。

Objective：To investigate incidence and high-risk factors of congenital hearing loss and explore screening methods.Methods： After bearimg 72 hours,living neonates would be checked by Otoaccoustic Emission（OAE）.All frist screening newborns would be checked by OAE again.Who did not pass was checked by ABR（Auditroy Brain Stem）.It was just ＂Not Pass＂that each of two ears did not pass.Who did not pass must be checked over twice.Results：8487 of 9756 passed（87.0%）.1270 newborns did not pass.After 42 days,1236 cases passed.The rate of passage was 99.6%.Eleven newborns were dignosed hearing defects.The rate of neonatal congenital hearing loss was 0.32%,and mild,moderate,sever grade were 9%,63.3%,27.3% respeclively,There was significant difference in neonatal hearing loss incidence between normal infants and infants with high-risk factors,and infants with high-risk factors would induce more neonatal hearing loss.Premature delivery,neonatal asphyxia,illness of hign bilirubin,birth abnormality were associated with neonatal hearing loss.Conclusion： Routine hearing screening is necessary.The incidence of congenital hearing loss is more higher in neonatal infants with high-rick factors.OAE and AABR are good methods to screen infants with high-rick factors of hearing loss.It is very important to monitor the abnormal infants.