952例新生儿未通过听力筛查的高危因素和听力学特点分析

The high-risk factors and audiology characteristics analysis of 952 cases of neonatal failed hearing screening

目的：分析婴幼儿未通过听力筛查的高危因素和听力学特点。方法检测对象来自2009年5月至2012年2月重庆及周边地区两次听力筛查未能通过而转诊到该科进行听力学评估的3～6个月的婴幼儿，共952例。采用听性脑干反应（ABR）、畸变产物耳声发射（DPOAE）、鼓室声导抗和镫骨肌反射测试。结果无高危组新生儿正常鼓室图比率为74．25％，高于高危组69．61％（P＜0．05）；无高危组新生儿DPOAE通过率为34．57％，高于高危组27．94％（P＜0．05）；无高危组新生儿波V反应阈大于30 dBnHL者为55．80％，高危组新生儿波V反应阈大于30 dBnHL者为60．36％，高危组新生儿ABR听力异常率明显高于健康新生儿（P＜0．05）；高危组新生儿听力阈值（50．58±25．02）dBnHL高于无高危组新生儿（47．64±22．86）dBnHL（P＜0．05）。结论听力损失的高危因素有新生儿窒息、早产、宫内病毒感染、高胆红素血症、体质量小于1500 g、机械通气大于或等于5d，以及大于或等于2个高危因素。

Objective To analyze the related factors in new born failed in hearing screening and its audiological characteristics . Methods From May 2009 to Febrary 2012 ,952 infants within the 3 to 6-month-old with detailed birth records and hearing screen-ing records were reviewed in the study .They were born in Chongqing and surrounding areas ,but failed in the first and second hear-ing screening .They were tested by auditory brainstem response （ABR） ,distortion product otoacoustic emissions （DPOAE） ,tympan-ometry and stapedius reflex .Results The normal ratio of tympanogram ,normal group（74 .25% ） was higher than the high-risk group（69 .61% ）（P〈0 .05）;The pass proportion of DPOAE in normal group（34 .57% ） was higher than high-risk group（27 .94% ） （P〈0 .05）;In normal group ,ABR response threshold 〉30 dBnHL was 55 .80% ,60 .36% in high-risk group .High-risk group′s hearing abnormality rate was significantly higher than the normal group （P〈0 .05）;In normal group ,mean threshold of ABR was （47 .64 ± 22 .86）dBnHL .While it was（50 .58 ± 25 .02）dBnHL in high-risk group .The threshold was higher in normal group than high-risk group（P〈0 .05） .Conclusion premature birth ,low birth weight（〈1 500 g） ,hyperbilirubinemia ,neonatal asphyxia ,pal-ace the virus infection ,mechanical ventilation ≥ 5 days ,≥ 2 high-risk factors are risk factors for hearing loss .Newborn hearing screening is a long and arduous task ,We should enhance screening efforts in infant with high risk factors ,and actively prevent and treat neonatal perinatal risk factors and reduce the incidence of hearing loss .