瞬态诱发耳声发射在新生儿听力普遍筛查中的应用

Transiently evoked otoacoustic emi ssions for universal newborn hearin g screening

目的(1)评价瞬态诱发耳声发射(TEOAEs)在新生儿听力普遍筛查中应用的可行性。(2)建立新生儿听力普遍筛查模式。方法对2094例新生儿(占全体96.23%)出院前行TEOAEs测试,未通过者1个月后复查TEOAEs,仍未通过者随后行听性脑干反应(ABR)检查,对通过OAE筛查的高危因素登记(HRR)新生儿定期随访。ABR检查不通过者在3个月内接受全面的听力学诊断和评估。结果1897例(90.59%)通过出院前筛查;1个月后191例复查,176例(92.15%)通过,15例接受ABR检查,5例未通过(33.3%)。最后确诊6例婴儿(2.87‰)有听力损失。结论应用TEOAEs进行新生儿听力普遍筛查是切实可行的。筛查模式就是对筛查、跟踪和随访、诊断、干预以及评估5项内容的具体实施。TEOAEs联合ABR三步法是适宜的筛查策略。对通过OAE测试的HRR婴儿定期随访。

Objective(1)To evaluate the feasibility of the universal newborn hearing screening p rogram using transiently evoked oto a-coustic emissions(TEOAEs );(2)To establish a suitable newborn hearing screening model.Methods 2094newborns,accounting for96.23%of all infants received TEOAEs screening before discharge.Those who didn' t pass the first screening were asked to return one month after discharge for TEOAEs rescreen ing.Those failed rescreening received ABR test.All infants who failed ABR test were referred for diagnostic evaluation.Following-up of the inf ants who have the high risk factors of hearing loss is needed.Results1897(90.59%)newborns passed the TEOAEs screening.176passed TEOAEs rescreening in one month.15infants referred for ABR test and 5failed.6i nfants were eventually confirmed to be hearing loss after di agnostic evaluation.Conclusions It is feasible to perform universal newborn hearing screening by using TEOAEs test.The screening model is t hat how to execute'Screening,Following-up and Track,Diagnosis,Intervention and Evaluation'.Three stages screening combined TEOAEs wi th ABR test is the ideal strategy for h earing screening.It is necessary to track the infants with high risk factors who pass the OAE screening.