919例新生儿听力筛查结果分析

Analysis of 919 cases of neonatal hearing screening

目的通过新生儿听力筛查，为早期婴儿听力障碍者进行最佳治疗提供依据。方法对2006年2至10月在西安交通大学医学院第一附属医院产科出生的正常新生儿及同期在新生儿科住院治疗的病理新生儿共919例进行了听力筛查，并对筛查结果进行了分析。结果正常新生儿初次听力筛查通过率为88．22％（442／501），单耳未通过率占8．1g％，双耳未通过率占3．59％；病理新生儿通过率为64．35%（269／418），单耳未通过率占21.53％，双耳未通过率占14．11％。病理新生儿通过率较正常新生儿有显著性差异（Х^2=74．15，P〈0．01）。病理新生儿中早产儿、新生儿肺炎、新生儿高胆红素血症及新生儿缺氧缺血性脑病患儿单耳未通过率分别为22．11％、21．95％、12．33％、26．19％；双耳未通过率分别为14．74％、14．63％、8．22％、14．29％。各组病理新生儿均较正常新生儿有显著性差异。单耳未通过的131例中按时复筛者仅69人（占52．67％），仍未通过1例；双耳未通过的77例中进行复筛者41例（占53．25％），仍未通过3例，其中重度缺氧缺血性脑病2例，早产儿1例。结论应按期进行新生儿听力筛查，不同疾病对听力筛查有不同的影响。

Objective To provide evidence for best therapy for infants with early hearing loss by neonatal hearing screening. Methods Hearing screening was conducted among 919 newborns, including normal neonates and pathological ones hospitalized in Neonatal Department at same period, delivered in First Affiliated Hospital of Medical College of Xi＇ an Jiaotong University from February to October 2006. The screening results were analyzed. Results The pass rate of first screening among normal neonates was 88.22% （442/501）. The neonates who failed in first screening in one ear occupied 8.18%, and in both ears occupied 3.59%. The pass rate of first screening among pathological neonates was 64.35% （269/418）. The neonates who failed the first screening in one ear accounted for 21.53% , and in both ears accounted for 14.11%. There was significant difference in pass rate between normal neonates and pathological ones （X2 =74.15, P 〈 0.01 ）. The incidence of failure in the first screening in one ear in preterm infants, infants with neonatal pneumonia, infants with neonatal hyperbilirubinemia and hypoxie-ischemie encephalopathy infants was 22.11%, 21.95% , 12.33% and 26.19%, respectively, and the incidence of failure in the first screening in both ears was 14.74% , 14.63% , 8.22% and 14.29% , respectively. There were significant differences between normal newborns and pathological newborns. Only 69 of 131 （ 52. 67% ） cases who failed in the first screening in one ear received re-screening and 1 case failed again. There were 41 cases not passing the first screening in both ears received re-screening and 3 eases failed again, including 2 severe hypoxic ischemie encephalopathy cases and 1 preterm infant. Conclusion Hearing screening on time is necessary for newborns. Different diseases have different effects on hearing screening.