3419例小儿听力筛查结果分析

Analysis of hearing screening results of 3 419 neonates

目的分析影响新生儿听力筛查通过率的相关因素。探讨新生儿听力筛查有效的模式。方法于2014年6月1日至2015年5月31日,采用ALGO3i筛查仪对自愿接受筛查的3 419例新生儿于出生后1~7天进行听力初筛,初筛异常者30~42d进行复筛。复筛异常者30天后进行二次复筛,仍未通过者转诊至第四军医大学西京医院耳鼻喉科进一步诊断和治疗。就性别、体重、母亲年龄、孕周、生产方式、耳别、新生儿NICU等情况否对听力筛查的通过率造成影响进行统计分析。结果初筛听力通过率为86.96%(2 973/3 419),未通过者中73.54%(328/446)参与了首次复筛,首次复筛通过率90.24%(296/328),仍未通过者的二次复筛率为75.00%(24/32),二次复筛通过率为33.33%(8/24),进一步明确诊断听力障碍检出率为4.09‰(14/3 419)。初筛的通过率与耳别和进入NICU治疗有关(x^2=4.41和10.33,P<0.05);首次复筛的通过率与母亲年龄、出生体重、孕周、进入NICU治疗有关(x^2=18.82~52.17,P<0.05),二次复查通过率与分娩方式和进入NICU治疗有关(x^2=4.11和4.00,P<0.05)。结论影响新生儿听力筛查通过率的因素有耳别、母亲年龄、出生体重、孕周、分娩方式、进入NICU治疗,多次听力筛查能有效降低听筛的假阳性率。

Objective To analyze the factors that affect the passing rate of heating screening in neonates and to explore the effective models for hearing screening in them. Methods During the period of June 1 st, 2014 to May 31 st, 2015, a total of 3 419 cases of neonates aged 1 - 7 days received preliminary hearing screening by using ALGO3i screener. Neonates with abnormal screening results underwent a rescreening when they were in 30 to 42 days after birth. As for neonates who didn＇ t pass the re-screening, they received a second rescreening 30 days later. Those who didn＇ t pass the second re-screening were transferred to the department of otorhinolaryngology in Xijing Hospital Affiliated to the Fourth Military Medical University for further diagnosis and treatment. Statistical analysis was carried out on the effects of factors like gender, birth weight, puerpera age, gestational weeks, delivery mode, ear side, and neonates＇ conditions in NICU on the passing rate of heating screening. Results The passing rate of preliminary screening was 86.96% （2 973/3 419 ）. Among those who didn＇t pass the preliminary screening, 73.54% （328/446） received the first re-screening. The passing rate of the first re-screening reached 90.24% （296/328）. However, as for those who failed to pass the first re-screening, 75.00% （24/＇32）of them received the second re-screening. Among them, 33.33% （8/24） of the neonates passed the second re-screening. The detection rate of heating impairment after further diagnosis amounted to 4.09%o （14/3 419）. The passing rate of the preliminary screening was related to neonates＇ ear side and their treatments in NICU （X2 value was 4.41 and 10.33, respectively, both P 〈 0.05 ）. The passing rate of the first rescreening was associated with the puerpera age, birth weight, gestational weeks, and neonates＇ treatments in NICU （X2 value ranged from 18.82 to 52. 17, all P 〈 0.05）. Influence factors of the passing rate of the second re-screening were delivery mode and neonates＇ treatments in NICU （X2 value was 4.11 and 4.00, respectively, both P 〈 0.05）. Conclusion The influencing factors of the passing rate of heating screening in neonates include ear side, puerpera age, birth weight, gestational age, delivery mode, and their treatments in NICU. Repeated heating screening can effectively reduce false positive rate.