1242例新生儿听力筛查结果分析

Analysis on the results of neonatal hearing screening among 1 242 newborns

目的分析新生儿听力筛查结果及相关影响因素。方法回顾性分析2013年6月-2014年6月出生的1 242例新生儿,根据新生儿高危诊断标准将新生儿分为正常组807例和高危组435例,应用畸变产物耳声发射(DPOAE)和听觉诱发电位(ABR)进行初步筛查和复查并进行听力障碍诊断,对可能影响听力损伤的相关因素进行分析。结果新生儿听力筛查率为99.20%(1 242/1 252),初筛通过率为98.55%(1 224/1 242),复查率为90.02%(1 118/1 242),复查通过率为60.02%(671/1 118);不同程度听力损伤的发生率为5.59%(25/447)。正常组的初筛通过率为99.75%(805/807)与高危组的96.32%(419/435)差异无统计学意义(P>0.05);而正常组复查通过率为78.31%(632/807)明显高于高危组的8.97%(39/435),差异有统计学意义(P<0.01);高危组新生儿听力损伤发生率为3.91%(17/435)显著高于正常组的0.99%(8/807),差异有统计学意义(P<0.05)。新生儿性别与听力损伤率之间的差异无统计学意义(P>0.05),而胎龄、分娩方式、出生体质量及患病情况与听力损伤率之间的差异具有统计学意义(P<0.05)。结论新生儿中有较高比例的听力损伤,早产儿、剖宫产儿、低出生体质量新生儿及合并患有其他疾病的新生儿的听力更容易受到损伤。临床上应对所有听力损伤的婴儿进行针对性治疗,以保证其身体健康。

Objective To analyze neonatal hearing screening results and the related influencing factors.Methods A total of 1 242 neonates born from June 2013 to June 2014 were analyzed retrospectively,then they were divided into normal group（ 807 neonates） and high-risk group（ 435 neonates） according to high-risk neonatal diagnostic criteria.Distortion product otoacoustic emission（ DPOAE） and auditory evoked potential（ ABR） were used for primary screening and secondary screening,the related influencing factors of hearing impairment were analyzed.Results The neonatal hearing screening rate was 99.20%（ 1 242/1 252）.The pass rate of primary screening was98.55%（ 1 224/1 242）,the secondary screening rate was 90.02%（ 1 118/1 242）,the pass rate of secondary screening was 60.02%（ 671/1 118）;the incidence rate of hearing impairment to different degrees was 5.59%（ 25/447）.The pass rates of primary screening in normal group and high-risk group were 99.75%（ 805/807） and 96.32%（ 419/435）,respectively,there was no statistically significant difference（ P〉0.05）;the pass rate of secondary screening in normal group was 78.31%（ 632/807）,which was statistically significantly higher than that in high-risk group（ 8.97%,39/435）（ P〈0.01）;the incidence rate of hearing impairment in high-risk group was 3.91%（ 17/435）,which was statistically significantly higher than that in normal group（ 0.99%,8/807）（ P〈0.05）.There was no statistically significant difference in the incidence rate of hearing impairment between boys and girls（ P〉 0.05）,but there were statistically significant differences among the neonates with different fetal age,delivery modes,birth weights,and sickness statuses（ P〈0.05）.Conclusion The incidence rate of hearing impairment is high among neonates,especially among premature infants,neonates born after cesarean section,low birth weight infants,and the neonates with other diseases.All the neonates with hearing impairment should be treated correspondingly to ensure their health.