关岭地区1519例儿童听力筛查结果及影响因素分析

Analysis of hearing screening results and influencing factors in 1519 children in Guanling area

目的通过在关岭县进行儿童听力筛查,了解当地儿童听力情况及听力筛查工作的开展情况,探索适合基层医院的儿童听力筛查方式。方法应用筛查型畸变产物耳声发射仪(DPOAE)对关岭县8所幼儿园1519例儿童进行听力筛查,未通过者经关岭县人民医院复筛,仍未通过者转入安顺市人民医院进行听力学诊断。结果1519例儿童,初筛通过1307例,通过率86.04%;212例到县人民医院复筛,通过162例,合计总通过率为96.7%。1519例儿童中964例(65%)未行新生儿听力筛查。是否患新生儿窒息(P=0.014)、父亲吸烟(P=0.038)组间儿童听力筛查未通过率有统计学差异。Logistic回归分析显示:早产(P=0.022)、新生儿窒息(P=0.026)、父亲吸烟(P=0.034)使儿童听力筛查不通过的风险增加。38例儿童接受纯音测听、声阻抗、行为测听、耳内镜等检查,结果分泌性中耳炎18例(36%),咽鼓管功能不良8例(16%),感音神经性听力下降3例(8.3%),经进一步检查诊断为听神经病1例,另外两例病因不明。结论本次研究儿童听力损失的主要原因为分泌性中耳炎,筛查型诱发性耳声发射(DPOAE)可作为基层医院儿童听力初筛的主要方式。

Objective To investigate the hearing status of local children and the development of hearing screening by conducting hearing screening in Guanling County,and to explore the hearing screening method of children in basic hospitals.Methods A total of 1519 children from 8 kindergartens in Guanling County were screened by distortion product otoacoustic emission instrument(DPOAE).Those who did not pass were screened by Guanling People s Hospital,and those who still did not pass were transferred to Anshun People’s Hospital for audiology diagnosis.Results Among 1519 children,1307 children passed the primary screening,and the pass rate was 86.04%;212 children were rescreened in the county people‘s hospital and 162 children were passed.The total pass rate was 96.7%.Among 1519 children,964 children(65%)did not undergo Neonatal hearing screening.There was significant difference in the failure rate of children’s hearing screening between the groups of whether suffering from neonatal asphyxia(P=0.014)and father smoking(P=0.038).Multivariate logistic regression analysis showed that premature(P=0.022),neonatal asphyxia(P=0.026),and father smoking(P=0.034)increased the risk of hearing screening failure in children.Thirty-eight children underwent pure tone audiometry,acoustic impedance,behavioral audiometry and otoendoscopy.Eighteen children(36%)were diagnosed as exudative otitis media,8 children(16%)as eustachian tube dysfunction,and 3 children(8.3%)as sensorineural hearing loss.One patient was diagnosed as auditory neuropathy by further examination.There was no identifiable cause in the other 2 patients.Conclusion The main cause of hearing loss in children in this group was exudative otitis media.Most children did not undergo neonatal hearing screening after birth.DPOAE may be used as the main method of primary hearing screening for children in basic hospitals.