基层医院新生儿听力筛查及相关影响因素

Universal Newborn Hearing Screening and Related Factors in the Community Hospital

目的：通过对新生儿听力筛查，探讨基层医院新生儿听力筛查的适宜时间、初筛通过率、新生儿听力异常发病率，并分析听力筛查相关影响因素。方法采用瞬态诱发耳声发射技术（TEOAE）对2010年1月至2012年12月在本院住院的5746例新生儿进行听力筛查，初筛未通过者于生后42d进行复筛，复筛仍未通过者，于生后3个月进行第3次筛查，未通过者采用脑干听觉诱发电位技术诊断，并对听力筛查者的相关影响因素统计分析。结果正常新生儿生后4-7d初筛通过率最高，初筛通过率为93.5%（5025/5374），高危儿初筛通过率为76.6％（285/372），两组差异显著。经听性脑干反应测试诊断为听力障碍6例，新生儿听力异常发病率为3.4‰。结论新生儿听力筛查可及早发现听力障碍，正常新生儿初筛时间以生后4-7d最佳，高危新生儿听力障碍的发生率高于正常新生儿，应重点监测。

Objective To investigate the optimal time、the suited mode、the incidence of newborn hearing loss,and to assess the related inlfuence factors of newborn hearing screening. Methods Transient evoked otoacoustic emission（TEOAE）was used in 5746 cases of newborn infants From Jan 2010 to Dec 2012. The primary hearing screening was in 1~7days after birth, Follow up screening was provided for those failed the initial screening after 42 days. Auditory brainstem response（ABR）was subsequeatly used to conifrm the diagnosis at the age of 3 months. Results The passing rate of the primary hearing screening in normal infants was the most highest in 4-7day after birth, the passing rate of the primary hearing screening in normal infants was 93.5%（5025/5374）.the passing rate of the infants with high-risk factors was 76.6%（285/372）, There was signiifcant diference in the primary hearing screening passing rate between the two groups. The 6 cases were diagnosed with hearing impairment by the auditory brainstem response（ABR）. The rate of neonatal congenital hearing loss was 3.4‰. Conclusion Newborns hearing impairment can be identiifed early by hearing screening, The best time to perform hearing screening for newborns with TEOAE was in 4-7day after birth., The incidence of congenital hearing loss is more higher in neonatal infants with high-risk factors, should be the focus of monitoring.