甘肃省农村地区新生儿听力初筛时间与通过率比较

摘要

目的 探索甘肃省农村地区新生儿普遍听力筛查最佳初筛时间,为甘肃省制定合理的新生儿听力筛查模式提供理论依据.方法 以2009年7月至2010年9月出生于甘肃省西部地区(酒泉、金昌、张掖、武威)的16121例新生儿为研究对象,分别于出生后48小时内(A组)、出生后48～72小时(B组)、出生后72～120小时(C组)采用畸变产物耳声发射技术进行初筛,未通过者于出生后42天进行复筛;仍未通过者分别于3月龄、6月龄采用听性脑干诱发电位等技术进行听力学诊断检查.结果 16121例新生儿接受听力筛查,总体初筛通过率为85.50％(13 784/16121),未通过率为14.5％(2337/16 121).A组正常儿5160例,初筛通过率为87.54％;高危儿330例,通过率为83.03％.B组正常儿8741例,初筛通过率为83.87％;高危儿556例,初筛通过率为88.31％.C组正常儿1232例,初筛通过率为87.91％;高危儿102例,初筛通过率为86.27％.卡方检验表明,正常儿A、B、C三组间初筛通过率差异显著,但高危儿三组间差异不显著.A组内正常儿初筛通过率显著高于高危儿(P＜0.05),B组内正常儿初筛通过率显著低于高危儿(P＜0.05).各地区间初筛通过率具有统计学差异,其中A组内酒泉初筛通过率显著低于金昌、张掖、武威三个地区,张掖初筛通过率显著高于武威.B组内武威初筛通过率显著高于酒泉及张掖地区.结论 初筛时间是影响新生儿听力筛查通过率的因素之一,随着初筛时间的延长,未通过率呈现逐渐下降的趋势.%Objective To determine the most appropriate time for universal newborn hearing initial screening in order to provide basis for establishing an appropriate protocol for newborn hearing screening in Cansu. Methods Sixteen thousand one hundred and twenty-one infants who were bom between July 2009 and September 2010 in the west part of Cansu Province (Jiuquan City, Jinchang City, Zhangye City and Wuwei City) were divided into three groups. Croup A received initial distortion product otoacoustic emission (DPOAE) test within 48 hours after birth, Croup B received the test between 48 and 72 hours, and Croup C between 72 and 120 hours. Infants who failed the initial screening were checked again 48 days later. Auditory brainstem responses (ABR) were subsequently used to verify DPOAE results at theage of three and six months. Results Of the tested newborns, 13784 (85.50%) passed and 2337 (14.50%) failed. The pass rate was 87.54% for the 5160 normal newborns and 83.03% for the 330 high-risk newborns in Group A. In Croup B, the pass rate was 83. 87% for the 8741 normal newborns and 88.31% for the 556 high-risk newborns. For Croup C, the rate was 87.91% for the 1232 normal newborns and 86.27% for the 102 high risk newborns. Chi-square tests showed significant difference among pass rates for normal infants in the three groups, but not for high risk infants., The pass rate for normal infants was higher than that for high-risk infants in group A (P < 0.05), but lower than that for high-risk infants in group B (P < 0.05). The initial screening pass rate was also different among different areas. For Group A, the pass rate in Jiuquan City was lower than in Jinchang City, Zhangye City and Wuvrei City. The pass rate in Zhangye City was higher than in Wuwei City. For Group B, the pass rate of Wuwei City was higher than Jiuquan City and Zhangye City. Conclusion The pass rate in initial hearing screening seems to increase along with increased age.