新生儿听力普遍筛查模式的建立与程序

Establishment and procedure of universal newborn hearing screening

目的:通过建立新生儿听力普遍筛查(universalnewbornhearingscreen-ingUNHS)模式,获得佛山地区出生婴儿听力损失的基本资料。方法:选择佛山市妇幼保健院2001-05-14/2002-12-25出生的活产新生儿在出院前接受耳声发射(otoacousticemissions,OAE)测试,通过者予出院;未通过者在出生42d复查OAE,仍未通过者行听觉脑干诱发电位(auditorybrainstemresponse,ABR)检查。所有ABR检查不通过者在3个月内接受全面的听力学诊断和评估,以确定听力损失的性质和程度。耳声发射测试采用畸变产物耳声发射(distortionproductotoacousticemis-sions,DPOAE)。结果:3244例新生儿中2910例(89.70%)初筛通过OAE测试,未通过测试的313例于生后42d复查OAE有309例通过。OAE测试总的通过率99.2%;接受ABR检查者共4例,3例未通过测试。经系统的听力学诊断与评估,此3例患儿伴有不同程度的听力损伤,占受试对象的0.92‰;新生儿重症监护病房中高危新生儿听力损伤的发生率(4.8‰,2/417)显著高于爱婴区未患病的新生(0.35‰,1/2827),差异有显著性意义(χ2=7.76,P<0.01)。结论:充分发挥保健机构特色建立OAE两步筛查、ABR初步诊断方案,对建立新生儿听力普遍筛查模式,促进听力筛查工作的普遍开展有重要作用。

AIM:To explore the basic information of the infant with hearing loss in Foshan area by establishing model and procedure of universal newborn hearing screening(UNHS). METHODS:Totally 3 244 neonates at live birth from May 14,2001 to December 25,2002 were tested by otoacoustic emissions(OAE) in Foshan Maternal and Child Care Hospital,normal case discharged after passing the test,and the abnormal cases who did not pass the test at primary were retested by OAE on the 42th day after birth,and the abnormal cases who did not pass the testament at the 2nd testament would be tested by auditory brainstem response(ABR).All the infants who were still abnormal in ABR would be diagnosed and evaluated by audiology in 3 months and then the degrees of hearing lose would be confirmed.OAE were made by distortion product otoacoustic emissions(DPOAE). RESULTS:Totally 89.7%(2 910/3 244) of infants passed the criteria at the primary OAE test,but 313 who did not pass were retested by OAE on the 4nd2 day after birth,and 309 of them passed.The total incidence of passage OAE test was 99.2%.Three of 4 infants(0.92‰of the cases who were tested)who did not pass the second OAE test were identified with hearing impairment at different degrees by the systemic audiologic evolution.The incidence of hearing impairment of the neonates(4.8‰,2/417) who were treated in neonate intensive care unit(NICU) was remarkably higher than that of those in the friendly baby care(0.35‰,1/2 827)(χ2=7.76,P< 0.01). CONCLUSION:The efficient development of health care's characteristic establishment two steps of screening in OAE,and primary diagnosis of ABR are important to the establishment of mode for universal newborn hearing screening and the improvement of its widespread development.