摘要
目的分析新生儿听力筛查结果,探讨其影响因素或危险因素,为临床治疗听力损伤提供指导依据。方法对4200例新生儿采用OAE初筛,采用OAE+AABR复筛,复筛未通过者去指定听力筛查诊断中心进一步检测;同时对高危因素患儿进行易感基因检测。结果①4200例新生儿,正常生产儿3817例,NICU 383例,初筛率100%,初筛未通过率为11.83%(497/4200,NICU 114例);复筛率78.5%(390/497),复筛未通过率为12.8%(50/390,NICU 38例)。无论是初筛还是复筛,NICU未通过率均高于正常新生儿。②对于50例复筛未通过新生儿,去淄博市妇幼保健院进行听力学评估和医学诊断。确诊感音神经性听力下降5例,其中正常生产儿1例(2%),NICU新生儿4例(8%),听损障碍中NICU比例较高。③产妇年龄过大、胎龄过小、胎重较小、Apgar(1min)<7分、耳毒性药物使用史、听力障碍家族史及羊水异常是先天性听力障碍的危险因素。④高危新生儿基因检测。9例基因检测异常(4.2%)。3例属于听力障碍家族史,2例初筛及复筛均未通过,确诊为感音神经性听力下降,1例正常;2例孕妇>40岁,初筛复筛均通过;3例为高胆红素血症患儿,1例复筛未通过,确诊为感音神经性听力下降;1例新生儿Apgar评分<7分,初筛复筛均通过。⑤对未进行复筛(107例)或未通过复筛(50例)共157例及9例基因检测异常新生儿进行随访;未进行复筛或未通过复筛157例,随访率63.7%;9例基因检测异常新生儿进行随访,随访率100%。结论①新生儿常规听力筛查至关重要,高危新生儿是听力障碍的高发人群,列为重点筛查对象,作到早发现、早治疗。②基因筛查,增加随访率,扩大了耳聋的防治与干预范围,为以后新生儿早期诊断及早期干预,提供有效依据。
Objective To report risk factors potentially affecting newborn hearing screening results and hearing to provide guidance for clinical management of deafness.Methods Transient evoked optoacoustic emissions(TEOAEs)and automatic auditory brainstem responses(AABRs)were used for hearing screening in 4,200 neonates,with OAEs for primary screening and OAEs+AABRs for secondary screening.In the mean time,heel blood or umbilical cord blood in high risk children were used to detect susceptibility genes.Hearing and gene screening results was carried out,for timely and appropriate intervention and treatment for newborns with hearing abnormalities.Results 1、All the 4200 neonates(383 in NICU)underwent initial hearing screening and 497(11.83%,including 114 in NICU)failed,of whom 390(78.5%)received rescreening and 50(12.8%,including 38 in NICU)failed.The failure rate of NICU neonates was higher than that of normal neonates.2、The 50 neonates that failed rescreening were referred to ZiBo Maternal and Child Care Hospital for audiological evaluation and medical diagnosis and sensorineural hearing loss was confirmed in 5,including 1 normal born(2%)and 4 in NICU(8%).3、Maternal age,gestational age,fetal weight,1min Apgar score<7,history of ototoxic drug usage,family history of hearing impairment and amniotic fluid abnormalities were risk factors for congenital hearing impairment.4、Genetic abnormality was detected in 9 neonates(4.2%).In 3 neonates with family history of hearing impairment,2 failed both primary screening and rescreening and were diagnosed with sensorineural hearing loss,1 was normal.The 2 babies whose mothers were>40 years old both passed the primary screening and rescreening.One of the 3 babies with hyperbilirubinemia failed rescreening and was diagnosed with sensorineural hearing loss.One newborn had Apgar score<7 but passed both primary and secondary screening.5、Among the 157 newborns that either were not rescreened or failed rescreening,63.7%were followed up,and all 9 newborns showing abnormal genes were fol
作者
赵洪春
车娟
张肖林
刘秀珍
徐舒舒
陈军
王延飞
ZHAO Hongchun;CHE Juan;ZHANG Xiaolin;Liu Xiuzhen;XU Shushu;CHEN Jun;WANG Yanfei(Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,Shandong,China;Clinical Laboratory,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,Shandong,China)
出处
《中华耳科学杂志》
CSCD
北大核心
2020年第4期734-739,共6页
Chinese Journal of Otology
基金
滨州医学院科技计划(No:BY2016KJ28)
国家自然科学基金(No:81500797)。
