桂林市新生儿听力筛查研究

Study on Newborn Hearing Screening in Guilin

目的探讨桂林市新生儿听力筛查的方法和模式。方法应用丹麦产Madsen Capeila耳声发射仪对我院新生儿进行听力筛查,选取1200例同时运用瞬态耳声发射(TEOAE)和畸变产物耳声发射(DPOAE)出生3～5天初筛,其中一种方法未通过者42天两种方法同时复筛,复筛未通过者3个月脑干诱发电位(ABR)诊断,异常者在6个月时再次复查ABR,两次ABR未通过者为听力损失。结果 1200例中初筛时有978例两种方法同时通过,有148例同时未通过,有36例仅TEOAE未通过,有38例仅DPOAE未通过;复筛时有188例两种方法同时通过,有25例同时未通过,有5例仅TEOAE未通过,有4例仅DPOAE未通过;有7例3个月内ABR未通过,至6个月时再次复查ABR,最后确诊不同程度听力损失3例,听力损失发病率2.5‰。结论耳声发射是适用于新生儿听力筛查的一种快速、无创、简便的方法,瞬态耳声发射(TEOAE)和畸变产物耳声发射(DPOAE)筛查通过率无显著差异,可早期发现听力损失新生儿,早期干预,其适宜时机为出生后3～5天,42天复筛有利于降低筛查假阳性率。

Objective To explore the newborn hearing screening way and model suitable in Guilin city. Methods The MADSEN CAPEILA otoacoustic emission made in Danmark was used for 1 200 normal newborns in our hospital to screen the heating. All 1 200 newborns received hearing screening test by transient evoked otoacoustic emissions （TEOAE） and distortion product otoacoustic emissions （DPOAE） in 72 - 120 hours and rescreened 42 days after they born by TEOAE and DPOAE. Those infants who failed to pass the rescreening test received auditory brainstem response （ABR） test in three month. Those infants who failed in the ABR test received ABR test again when they were at six month. Results 978 newborns passed the TEOAE and DPOAE screening in 72 - 120 hours, 148 failed TEOAE and DPOAE at the same time, 36 failed TEOAE, 38 failed DEOAE. 188 passed the TEOAE and DPOAE screening in rescreening test, 25 failed TEOAE and DPOAE in rescreening test, 5 failed TEOAE and 4 failed DEOAE in rescreening test. 7 infants received ABR test failed to pass at their three month old, but 4 infants passed ABR test in their six month old. 3 infants had been confirmed heating loss. The data display that invasion rate of hearing weakness was 2.5%0. Conclusions Otoacoustic emission is a fast, feasible and non-hurt method. The pass rates of neonatal heating screening between TEOAE and DPOAE has no difference, neonatal heating weakness can be indentified early and provide amplification early method for screening of neonatal hearing. It is feasible model to carry out in our country that two stage screening combined, and it can reduce False positive.