学龄前儿童听力筛查方法与效果评估

Investigation on Preschool Hearing Screening Method and Effect

目的通过对全市学龄前儿童听力筛查数据进行分析,探讨学龄前儿童听力筛查的准确性和有效性。方法2015~2017年我院和全市区、县妇幼保健机构协作开展学龄前儿童听力筛查。根据儿童耳及听力保健技术规范要求,分别采用便携式听觉评估仪和耳声发射法进行筛查。结果2015年164182名儿童进行了听力筛查,7023名(4.28%)经复筛未通过。2016年228271名儿童进行了听力筛查,7547名(3.31%)经复筛未通过。2017年262404名儿童进行了听力筛查,11205名(4.27%)经复筛未通过。两种筛查方法比较,筛查未通过率耳声发射法明显高于便携式听觉评估仪法。经复筛未通过的儿童中,2015年549名(7.8%),2016年346名(4.58%),2017年542名(4.84%)儿童,转诊至我院听力检测中心进行了听力学的诊断性评估。结论学龄前儿童听力筛查建议采取耳声发射法等客观筛查的方式进行,降低假阴性率,避免听力损失儿童漏诊。

Objective This paper analyzes the preschool hearing screening data in kindergartens of 2015-2017,aims to ascertain how to perform hearing screening for preschool children more effectively,and improve the accuracy and effectiveness of screening.Methods A total of 654,857 children were screened by trained lay screeners using a portable audiometer and OAE equipment according to“Technical specification for ear and hearing health care for children”.The screening and follow-up protocol specified that children who failed the two-step screening must be evaluated by hearing diagnostic department.Result In 2015,164,182 children were screened and 7,023(4.28%)required diagnostic follow-ups.In 2016,228,271 children were screened and 7,547(3.31%)required diagnostic follow-ups.In 2017,262,402 children were screened and 11,205(4.27%)required diagnostic follow-up.Ultimately,those children who required referral(549 from 2015,346 from 2016 and 542 from 2017)came to our hospital receiving medical or audiological evaluation.Conclusion Objective test such as OAE screening was found to be a feasible and accurate practice to reduce the false negative rate and avoid missed diagnosis of children with heating loss.