听力筛查未通过新生儿初次听力诊断结果分析.docVIP

听力筛查未通过新生儿初次听力诊断结果分析 　　【摘 要】 目的：分析听力筛查未通过的新生儿初次听力诊断的结果，为随防、指导及早期干预治疗提供参考依据。方法：对43568例新生儿出生后3―5天用耳声发射仪进行初筛，初筛未通过者在出生后42天内进行复筛，复筛未通过者在出生后3月内用脑干听觉诱发电位仪、声导抗、诊断型耳声发射进行听力障碍的诊断。结果：43568例新生儿复筛未通过者802例，进行初次诊断者660例，占全部听力筛查儿的1.51%，其中256人出现不同程度的听力损失，听力损失占诊断人数的比率为38.79%，在听力筛查儿中的发生率为5.88‰；重度聋在听力筛查儿中的发生率为1.45‰；听力正常占诊断人数的比率为61.21%。鼓室积液占听力损失组总数的56.64% （145/256）；鼓室积液占听力正常组总数的27.23% （110/404）；鼓室积液率在听力损失组与听力正常组有显著性差异 （χ2检验，p0.01）。结论：听力筛查复筛未通过的新生儿中，初次诊断约1/2以上听力正常，约1/2听力损失伴有鼓室积液，筛查中应加强随访工作和妇幼保健宣教。 　　【关键词】听力筛查，听性脑干反应，声阻抗，鼓室积液，耳声发射 　　【中图分类号】R174 【文章标识码】A 【文章编号】1004-7484（2014）04-1945-02 　　Analysis of the first hearing diagnosis among neonates who failed hearing screening 　　Sun lei1， guo ling， yang jing jing， liu ying， lin chan chan， liu li 　　Hearing center， Jining maternal and child care hospital 　　【Abstract】The first hearing diagnosis of newborns who failed hearing screening were analyzed to provide reference for follow up and intervention. Methods： Hearing diagnosis were performed among those newborns who failed the second screening， acoustic impedance， otoacoustic emission and auditory brainstem response were used to complete diagnosis. The diagnosis time was beneath 3 months age. Results： Different degrees of hearing loss were detected in 256 neonates， hearing loss occurrence rate was 5.88‰ among hearing screening neonates，serious deafness rate was 1.45‰. Normal hearing rate was 61.21% among those neonates who received diagosis. 145 neonates were found tympana effusion among 256 neonates with hearing loss （56.64%）. Tympana effusion occurrence rate was higher in hearing loss neonates than that in normal hearing neonates （χ2- test ，p0.01）. Conclusion： Half or more than half of neonates who failed hearing screening were found normal hearing and about half of hearing loss neonates were found tympana effusion among the first diagnosis. Follow up and Maternal and Child Health Missions should be emphasized. 　　【Key words】Hearing screening，Auditory brainstem response，Acoustic impedance，