新生儿听力筛查质量的影响因素分析

Experience of improving the quality of neonatal hearing screening

目的探讨在新生儿听力筛查中如何采取相应措施以提高筛查质量。方法对835例新生儿采用畸变产物耳声发射进行听力筛查，经过第1、2、3次听力筛查，最终5例未通过，经听性脑干反应测听（ASR）检查确诊听力障碍3例。筛查过程中不断总结经验，以提高筛查质量。结果筛查新生儿835例，未通过率0．60％。ABR确诊听力障碍发病率0．36％，听力筛查阳性率0．24％。结论新生儿听力筛查过程中应注意：通过选择筛查时问；清洁外耳道并行电耳镜检查；控制环境噪声，根据新生儿状态调整测试方法；检测较准耳声发射听力筛查仪器，选择合适耳塞，正确放置探头；结合声阻抗检查，并对听力筛查通过的高危新生儿进行长期听力随访，可提高筛查质量，降低假阳性率以及避免假阴性的发生。

Objective To investigate the measures to improve the newborn hearing screening quality. Methods 835 cases of neonates using distortion product otoacoustic emissions for hearing screening,after first,second and third hearing screening, the final 5 cases failed, diagnosed by ABR screening hearing handicap in 3 cases. Experience constantly was summed up during screening process to improve screening quality. Results 835 newborns were screened. The rate of failing to hearing screening was 0.60% ,the rate of hearing impairment diagnosed by ABR was 0. 36%, and the positive proportion of hearing screening was 0.24%. Conclusion Our experience during screening progress is to take some measures to improve the newborn hearing screening quality, with reducing false positives and avoiding false negatives, by choosing screening time, cleaning external ear and electric-otoscopy examination, environmental noise control, updating test procedures according to the physiology and development of the newbo- rns,testing calibration instruments of otoacoustic emissions hearing screening, selecting suitable earplug, probe with correct place, and combining acoustic impedance examination,with a long term follow-up of listening in high risk neo-nates with passing screening.