3592例新生儿听力筛查回顾性分析

摘要

目的 了解新生儿听力损失的发病情况.方法 回顾性分析了2013年至2014年在我院出生的3592例新生儿听力筛查的结果,其中包括正常足月儿2891例,早产儿166例,低体重儿61例,轻中度窒息儿69例,以及宫内窘迫儿405例,采用瞬态诱发性耳声发射筛查仪进行初复筛.对于复筛仍未通过者,再行耳声发射、声导抗、听性脑干反应(ABR)检查,进行听力学综合评估后确诊.结果 出生后48~72小时接受初筛3592例,初筛率达到99.42%.初筛未通过人数457例,其中单侧未通过299例,双侧未通过158例,初筛未通过率平均13.26%.产后42 d应复筛人数为457例,实际复筛人数360例,实际复筛率78.77%,复筛未通过人数79例,复筛未通过率21.94%,正常足月儿听力初筛通过率为90.10%(2601/2891),早产儿为72.8%(121/166),低体重儿为75.4%(46/61),轻、中度窒息儿为69.5%(48/69),宫内窘迫儿为83.9%(340/405).确诊听力损失的患儿15例,正常足月儿共5例,占这类新生儿的0.17%,听力障碍高危因素儿(早产儿、低体重儿及轻、中度窒息儿、宫内窘迫儿)10例,占该类新生儿的1.43%.结论 早产儿、低体重儿及轻、中度窒息儿、宫内窘迫儿听力初筛的通过率明显低于正常足月儿,且确诊为听力损失的患儿所占比例显著高于正常新生儿.%Objective To investigate the incidence of newborn hearing loss.Methods We retrospectively analyzed the results of hearing screening in 3,592 newborns from 2013 to 2014 in our hospital,including 2,891 normal full term infants,166 premature babies,61 low weight births,69 with mild-to-moderate suffocation and 405 with fetal distress.We used transient evoked otoacoustic emissions(TEOAE)for both primary and secondary screening.Upon failing second-ary screening,the baby was referred for diagnostic otoacoustic emissions,acoustic immittance and auditory brainstem re-sponse(ABR)evaluation.Results The 3,592 newborns were screened within 48-72 hours after birth(primary screening rate=99.42%).Four hundred fifty seven of the 3,592 babies(13.26%)failed the primary screening(unilaterally in 299 and bilaterally in 158).Of the 457 babies failing the primary screening,360(78.77%)received secondary screening on postpartum day 42,with 79(21.94%)failing again.The pass rate in primary screening was 90.10%(2601/2891)for nor-mal term babies,72.8%(121/166)for premature newborns,75.4%(46/61)for those with low birth weight,69.5%(48/69)in those with mild-to-moderate suffocation and 83.9%(340/405)in those with fetal distress.Hearing loss was diag-nosed in 15 newborns,including 5(0.17%)of the normal term newborns.Hearing impairment risk factors(premature birth,low birth weight,mild-to-moderate suffocation and fetal distress)were identified in 10(1.43%)of the newborns. Conclusion Hearing screening pass rate in premature and low birth weight newborns and newborns with mild to moder-ate suffocation or fetal distress is lower compared to normal term newborns,with more of these babies likely to be diag-nosed with hearing loss.