听力学检查结果预测新生儿听力损失程度及类型的研究

摘要

Objective To explore the predictive effect of ABR on the degree of hearing loss and the types of newborn hearing screening.Methods Selected 485 neonates with hearing screening in our hospital from 2008.1 to 2014.12,Used ABR detection,acoustic detection,40Hz hearing related potential detection,DPOAE detection method for newborn frist screening,second screening and review.Results 485 cases of neonatal ABR hearing loss screening found 49 cases of mild (10.10％),31 cases of moderate (6.60％),30 cases of severe (6.19％),23 cases of very severe(4.74％),the left ear hearing loss accounted for 13.20％,accounted for 14.23％ of the right ear hearing loss,ABR hearing loss screening found in 33 cases (6.80％),25 cases of mild to moderate (5.15％),22 cases of severe (4.54％),14 cases of very severe (2.89 ％),the left ear hearing loss accounted for 9.90 ％,accounted for 9.48 ％ of the right ear hearing loss,early screening,the left and right ear hearing loss cases no significant the difference (P＞0.05).485 cases of neonatal ABR hearing loss screening found 84 cases of sensorineural hearing loss (17.32 ％),17 patients with conductive hearing loss (3.51％),32 cases of mixed deafness (6.60％),ABR hearing loss screening found 59 cases of sensorineural hearing loss (12.16％),16 patients with conductive hearing loss (3.30％),19 cases of mixed deafness (3.92％),with significant sensorineural hearing loss (P＜0.05).485 cases of neonatal ABR hearing loss screening found 434 cases of A type acoustic impedance peak type (89.48％),19 cases of type As acoustic impedance peak type (3.92％),31 cases of type B acoustic impedance peak type (6.39％),1 cases of type C acoustic impedance peak (0.21％);hearing loss screening found 452 cases of type A acoustic impedance peak type (93.20％),9 cases of type As acoustic impedance peak type (1.86 ％),23 cases of type B acoustic impedance peak type (4.74 ％),1 cases of type C acoustic impedance peak (0.21％),ABR hearing loss at the beginning,the sound of the compound sieve was not significant difference between the peak type (P＞0.05).Conclusion In newborn hearing screening,the ABR test has no predictive effect on the degree of hearing loss in the left and right ears,but it can predict the type of newborn hearing loss.Screening and diagnosis of neonatal hearing screening and follow-up mechanism should be set up after the newborn screening.%目的 探讨新生儿听力筛查中听性脑干反应(auditory brainstem response,ABR)对听力损失程度及类型的预测作用.方法 选择2008年1月-2014年12月来我院行听力筛查的新生儿485例,利用ABR检测、声导抗检测、40Hz听觉相关电位检测、畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)检测方法对新生儿进行初筛、复筛及复查.结果 485例新生儿ABR听力损失初筛发现49耳轻度(10.10％)、31耳中度(6.60％)、30耳重度(6.19％)、23耳极重度(4.74％),左耳听力损失占13.20％,右耳听力损失占14.23％;ABR听力损失复筛发现33耳轻度(6.80％)、25耳中度(5.15％)、22耳重度(4.54％)、14耳极重度(2.89％),左耳听力损失占9.90％,右耳听力损失占9.48％,初、复筛左右耳听力损失例数无显著性差异(P＞0.05).485例新生儿ABR听力损失初筛发现84耳感音神经性聋(17.32％)、17耳传导性聋(3.51％)、32耳混合性聋(6.60％),ABR听力损失复筛发现59耳感音神经性聋(12.16％)、16耳传导性聋(3.30％)、19耳混合性聋(3.92％),以感音神经性聋耳数显著(P＜0.05).485例新生儿ABR听力损失初筛发现434耳A型声导抗峰型(89.48％)、19耳As型声导抗峰型(3.92％)、31耳B型声导抗峰型(6.39％)、1耳C型声导抗峰型(0.21％);ABR听力损失复筛发现452耳A型声导抗峰型(93.20％)、9耳As型声导抗峰型(1.86％)、23耳B型声导抗峰型(4.74％)、1耳C型声导抗峰型(0.21％).ABR听力损失初、复筛声导抗峰型变化差异不显著(P＞0.05).结论 在新生儿听力筛查中,ABR检测对左右耳听力损失程度无预测作用,但可预测新生儿听力损失的类型.在新生儿筛查后更应建立健全新生儿听力筛查及诊断网络随访机制.