摘要
目的探讨自动听性脑干反应（automated auditory brainstem response，AABR）技术在新生儿听力筛查中的应用价值，分析新生儿听力障碍的高危因素。方法对2009年3月1日至2011年10月31日期间，第三军医大学大坪医院野战外科研究所产科出生的活产儿共4961例进行回顾性分析，其中4833例在出生后48～72h采用Alg03i型AABR听力筛查仪进行初筛，单耳或双耳未通过者于出生后30～42d进行复筛，复筛仍未通过者进行进一步检查及诊断。记录新生儿的胎龄、性别、出生体重、身长、娩出方式、Apgar评分以及是否进人新生儿重症监护病房（neonatal intensive care unit，NICU）治疗，分析上述因素对听力筛查通过率的影响。组间比较采用7。检验。结果（1）初筛率97．4％（4833／4961），初筛通过率90．3％（4362／4833）。471例初筛未通过（双耳77例，右耳154例，左耳240例），其中33例失访，复筛率93．0％（438／471），复筛通过率91．3％（400／438）。（2）38例婴儿复筛未通过，其中18例拒绝进一步检查，12例经过进一步检查未发现异常，8例确诊为听力障碍。初筛的敏感性和假阳性率分别为8／8和8．7％（418／4780），初筛和复筛总体的假阳性率为0．4％（18／4780），听力障碍检出率为1．67‰（8／4788）。（3）有窒息史的新生儿初筛通过率低于无窒息史者[79．4％（27／34）与90．3％（4335／4799），X^2=4．577，P〈0．063，左耳通过率低于右耳[93．4％（4516／4833）与95．2％（4602／4833），X^2=14．307，P〈0．05]，因各种原因进入NICU治疗的患儿通过率低于未进入NICU的新生儿E46．9％（113／241）与92．5％（4249／4592），X^2=542．336，P〈0．053，差异均有统计学意义。不同出生体重、娩出方式、性别、胎龄、身长的新生儿比较，初筛通过率差异均无统计学意义（P〉0．05）。结论AABR技术是有效的新生儿
Objective To investigate the significance of automated auditory brainstem response （AABR） technique in newborn hearing screening and the high-risk factors of newborns hearing disturbance. Methods From March 1,2009 to October 31,2011, 4961 newborn infants were born in the Department of Obstetrics, Daping Hospital, the Third Military Medical University, among which 4833 cases received preliminary hearing screening by AABR （Algo3i equipment） at 48 72 h after birth. Those who failed in the preliminary screening received secondary screening at 30-42 d after birth. Those who failed again were referred to further investigations for final diagnosis. The gestational age, gender, body weight, body length, delivery mode, Apgar score and whether to be hospitalized in neonatal intensive care unit （NICU） of each newborn were recorded. The association between each factor and hearing screening passing rate was analyzed. Chl-square test was used to compare the results of different groups. Results （1） The preliminary screening rate was 97. 4% （4833/4961） with a passing rate of 90.3% （4362/4833）. Four hundred and seventy-one infants did not pass the preliminary screening （77 cases for both ears, 154 cases for right ear and 240 cases for left ear）, among which 33 infants were lost in follow-up. The secondary screening rate was 93.0% （438/471） with a passing rate of 91.3% （400/438）. （2） Thirty-eight infants did not pass the secondary screening, among which 18 cases rejected to receive further examination, and 12 eases showed normal and 8 cases were diagnosed as hearing disturbance by further examination. The sensitivity and false positive rate of preliminary screening with AABR were 8/8 and 8.7% （418/4780） respectively. The total false positive rate of both preliminary and secondary screening were 0.4% （18/4780）. The detection rate of hearing disturbance was 1.67‰ （8/4788）. （3） In preliminary screening, the passing rate of infants with asphyxia was lower than that of those wit
出处
《中华围产医学杂志》
CAS
北大核心
2013年第4期227-231,共5页
Chinese Journal of Perinatal Medicine
关键词
诱发电位
听觉
脑干
听力
听力障碍
新生儿筛查
Evoked potentials, auditory, brain stem
Hearing
Hearing disorders
Neonatal screening
