黄石市2025例学龄前儿童听力筛查结果分析

摘要

Objective To obtain suitable hearing screening methods for preschool children.Methods A total of 2025 children aged 2~6 years old in 30 kindergartens in Huangshi City were selected by random sampling method.Acoustic impedance and otoacoustic emission tests(transiently evoked otoacoustic emissions and distortion product otoacoustic emissions) were performed in two stages of preliminary hearing screening.The children who failed the hearing screening needed to do the re-creening with the same methods;the children who failed the rescreening needed to receive audiological tests including ABR, ASSR examination and imaging examinations.Results The total screening pass rate was 94.02%, of which 1 842 passed the preliminary hearing screening(90.96%, 1 842/2 025).The 183 children who failed the preliminary hearing screening received the re-screening, 62 children passed the re-screening(33.88%,62/183).121 children failed the re-screening(5.98%,121/2 025), and finally 72 children(3.56%,72/2 025)were diagnosed with hearing loss, including 47 cases of otitis media,22 cases of sensorineural hearing loss(8 cases were moderate, 4 cases were severe hearing loss,10 cases were profound);18 cases were unilateral hearing loss while 4 cases were bilateral hearing loss.Conclusion Acoustic impedance and otoacoustic emission tests can be used for hearing screening in preschool children.The hearing problems of preschool children in Huangshi City were concentrated mainly in the middle ear secretory otitis media and different degree of sensorineural hearing loss.%目的 探讨学龄前儿童的听力筛查方式及其可行性.方法 采用随机抽样法抽取黄石地区30所幼儿园共2 025例2~6岁儿童,以声导抗、瞬态诱发耳声发射和畸变产物耳声发射检测进行听力初筛,未通过者一个月后同法进行复筛,复筛未通过者行纯音听阈测试或行为测听、听性脑干反应(auditory brain-stem response,ABR)、听性稳态反应(auditory steady-state response,ASSR)及影像学等检查.结果 本组对象听力初、复筛总通过率为94.02%(1 904/2 025),其中初筛通过者1 842例(90.96%,1 842/2 025);183例初筛未通过者进入复筛,其中62例通过复筛(33.88%,62/183),121例未通过2次筛查(5.98%,121/2 025);最终有72例(3.56%,72/2 025)诊断为听力损失,其中,分泌性中耳炎47例;感音神经性聋22例(中度8例,重度4例,极重度10例),单耳18例,双耳4例;单侧外耳道畸形伴不同程度耳道闭锁3例,其中,2例伴双耳大前庭水管综合征.结论 耳声发射及声导抗检测可用于学龄前儿童听力筛查;黄石地区学龄前儿童听力损失的原因主要为分泌性中耳炎和不同程度的感音神经性听力损失.