摘要
目的:对2次听力筛查未通过并伴有听力损失高危因素的婴幼儿进行客观听力评估,总结高危儿听力损失情况及变化特点。方法:对244例(488耳)2次听力筛查未通过或2次筛查结果不一致的婴幼儿采用听性脑干反应(ABR)、畸变产物耳声发射(DPOAE)、鼓室声导抗和镫骨肌反射等客观听力测试。结果:①3次OAE结果间存在一定的波动性,右耳的通过率要高于左耳。②第3次OAE评估通过的184耳中有45耳ABR异常,两项检查的不符合率高达24.5%(45/184);DPOAE不通过的304耳中有20耳ABR正常,不符合率为6.6%(20/304)。③按评估时患儿年龄进行分组,各组中ABR轻度异常比例最高,ABR正常在各组中也有很大的比例。评估年龄<3个月组ABR中度异常率明显高于其他两组(P<0.01),ABR重度异常率在各评估年龄组间差异无统计学意义(P>0.05)。④鼓室导抗曲线以A型为主,在不同程度听力损失婴幼儿中均超过70%(P>0.05),ABR中度异常组B峰检出率明显高于其他组(P<0.05);重度异常组检出1耳C型峰。⑤高危因素分布以高胆红素血症为主(29.5%),远高于其他因素(P<0.05)。结论:具高危因素的婴幼儿听力损失以轻度为主,其听力损失具有一定的波动性。随着年龄增长,有些中度异常有好转的趋势。对高危儿的听力评估需多次检测或结合多种方法方能得出正确结论。
Objective：To evaluate the characters and hearing changes of the infants failed in hearing screening with high-risk factors for hearing loss.Method：Two hundred and forty-four infants（488ears）who failed in the hearing screening or with the different results between the first and second screening,were tested by auditory brainstem response （ABR）,distortion product otoacoustic emissions （DPOAE）and acoustic immittance measurement in this study.Result：①A little proportion results among the three DPOAE screening was variable,the pass rate in the right-ear was higher than that in the left-ear.②Forty-five of 184ears which had passed the third DPOAE evaluation had the abnormal ABR results,the discrepancy rate between the two methods was 24.5% （45/ 184）;20of 304ears which failed in the hearing screening had a normal ABR results,with the discrepancy rate of 6.6% （20/304）.③The highest proportion of abnormal result of the ABR in each groups was mild hearing loss, normal ABR in each groups also had a large proportion.The proportion of moderate hearing loss in the group of no more than three months old infants was significantly increased compared with the other two groups（P0.01）, and no significant difference of severe hearing loss among the three groups（P0.05）.④More than 70%of type A tympanogram was found in each groups（P0.05）,the ratio of type B in moderately abnormal group was higher than other groups.Type C was only detected in one ear with severe hearing loss.⑤29.5%infants had suffered the hyperbilirubinemia,which was much higher than the other risk factors （P0.05）.Conclusion：The hearing loss of infants with high-risk factors are mostly mild,and show some indication of fluctuating.Some moderate hearing loss have the tendency to changes better.The combined use of electrophysiological measures can improve the accuracy of hearing evulation.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第16期725-729,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
广州市医药卫生科技项目(No:2008-YB-209)
关键词
听力筛查
听性脑干反应
畸变产物耳声发射
高危因素
评估
hearing screening
auditory brainstem response
distortion product otoacoustic emissions
high risk factors
evaluation
