摘要
目的:比较分析不同筛查方式(OAE/AABR)和不同筛查条件(有无听力损害高危因素)下未通过听力筛查的患儿的听力状况。方法:选取广州市出生后3个月内2次或2次以上新生儿听力筛查单耳或双耳未通过而转诊来进行听力评估者,共3 251例(6 502耳)。所有评估对象按最后一次听力评估时的月龄大小分为<6个月组(2 683例)和≥6个月组(568例),比较分析年龄因素对听力评估结果的影响。按接受听力筛查方式的不同分为OAE组和AABR组(AABR加OAE筛查或AABR筛查),比较分析不同筛查方式的特异性和敏感性。按围生期有无新生儿听力损失的危险指标分为重点患儿和普通患儿,比较分析高危因素对婴幼儿听力的影响及特点。所有评估对象双耳均进行ABR、DPOAE、声导抗测试,部分加做ASSR和(或)颞骨薄层CT扫描。结果:①该地区听力筛查初筛率在85.30%～86.54%,复筛率最高为64.10%;数据以完整的2008年和2009年统计,筛查出需即时助听干预患儿的发生率分别为0.028 2%和0.022 0%。②按不同筛查患儿比较,听力评估结果为中度及其以上异常者的比例,普通患儿低于重点患儿。③按不同筛查方式比较,听力评估结果为正常者的比例,AABR筛查不通过者低于OAE筛查不通过者;听力评估结果为重度及其以上者的比例,AABR筛查患儿高于OAE筛查患儿。结论:①AABR筛查方式优于OAE,伴听力损害高危因素者是新生儿听力筛查重点关注的患儿,作好新生儿围生期的登记非常必要;②广州市每年出生的需即时助听干预患儿的发生率不低于0.028 2%～0.022 0%。
Objective：To analyze the audiological characteristics of the cases who failed the newborn hearing screening under the two hearing screening programs（OAE and AABR） in two different screening population（with or without high-risk of hearing loss）.Method：Three thousand two hundred and fifty-one babies（6 502 ears） who failed the hearing screening twice or more and then failed in the audiological evaluation are included in the research.The cases were divided into two groups by the time accepting the screening,6（2 683 cases） months or ≥6 months（568 cases）,and then analyze the effect of age on the audiological characteristics.Compare the sensitivity and specificity of different hearing screening programs,OAE or AABR.Evaluate the audiological characteristics between the groups with or without the high-risk factors of hearing loss.Total of them were performed detailed audiological evaluation including in ABR,DPOAE,acoustic immitance,and some of them accepted ASSR test and computer tomography.Result：85.30% to 86.54% infants accepted initial screening in Guangzhou city,and less than 64.10% infants underwent rescreening.0.028 2% or 0.022 0% infants needed immediately early intervention.The group without high-risk factors was less likely to suffer from mild to profound hearing loss than those with high-risk factors.According to different hearing screening programs,more cases passed the OAE hearing screening and more cases were diagnosed profound hearing loss under AABR screening.Conclusion：AABR screening technology is better than OAE screening.The target population is the infants with risk factors,so perinatal history record is very important.The percentage of population who need immediately early intervention is more than 0.0282%-0.0220%.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2011年第13期577-581,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
