目的 探讨声诱发反应在胎儿听力筛查中的可行性.方法 对前来我院产科就诊的24231位孕妇进行产前胎心监测和声诱发反应测试以及其产后的新生儿听力筛查与诊断.按不同刺激声强度是否诱发出胎心反应进行分组,其中A组为105dB引出反应,4982人;B组为110dB引出反应,5893人;C组为115dB引出反应,6017人;D为120dB引出反应,5165人;E组为120dB仍无法引出反应,2174人.结果 A组至D组听力损失检出率缓慢上升,至E组时剧增,整组差异有统计学意义(χ2=132.30,P=0.000<0.05);A~D各组之间两两相比,差异无统计学意义.E组(13.34‰)显著高于A组(0.60‰,χ2=55.16)、B组(0.85‰,χ2=59.04)、C组(1.16‰,χ2=54.11)及D组(2.13‰,χ2=35.47),差异均有统计学意义(P<0.005).声强级别越小的组,其听力损失检出率越低,且多为单耳或者轻、中度;声强级别越大的组,其听力损失检出率越高,且多为双耳或者中、重度及以上听力损失.结论 声诱发反应在胎儿听力筛查、监测中是可行的,可作为一种安全、便捷的监测手段供临床选择使用.%Objective To explore the feasibility of acoustic stimulation test in fetal hearing screening.Methods A total of 24,231 pregnant women seen at our obstetrics department consented to prenatal fetal heart rate monitoring and acoustic stimulation test and results were compared to neonatal hearing screening and diagnosis.Patients were grouped according to the acoustic stimulation intensity threshold in inducing fetal heart rate responses,i.e,105 dB(Group A,n=4,982),110 dB(Group B,n=5,893,115 dB(Group C,n=6,017),120 dB(Group D,n=5,165 and beyond 120 dB(Group E,n=2,174).Results The rate of hearing loss increased gradually from Group A(0.60‰)to D(2.13‰),showing no sta-tistically significant difference,and increased sharply in group E(13.64‰)(χ2=132.30,P=0.000).Not only the rate of hearing loss was lower in lower stimulation threshold groups,hearing loss in these groups also tended to be of milder de-grees and in one ear,whereas the opposite was true in higher stimulation threshold groups.Conclusions Acoustic stimu-lation testing is feasible in fetal hearing screening and monitoring,while being safe and easy to use in the clinic.
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