4085例新生儿自动听性脑干反应筛查结果分析

摘要

Objective:To explore the clinical significance of newborn hearing screening in the diagnosis of neonatal hearing disease.Method:4085 newborns in our hospital from June 2013 to March 2015 were selected as the research objects.They were given automatic listen to brainstem response (AABR) for hearing screening.The influence of different delivery methods,high-risk infants(premature,hyperbilirubinemia,suffocate),maternal age and gender to the screening results were analyzed.Result:4085 infants completed ABBR screening within 2 to 5 days after the birth.3423 cases passed the screening for the first time,which accounted for 83.8%,662 cases didn’t get through the screening, which accounted for 16.2%.606 cases passed the compound sieve,which accounted for 14.8%,56 cases didn’t get through the compound sieve,which accounted for 1.4%.Among the newborns who didn’t pass the compound sieve,18 cases were diagnosed with hearing impairment,which accounted for 0.44%.In the natural birth newborns,the number of newborns who passed the screening for the first time was more than that in the cesarean section newborns.In the high risk newborns,the number of newborns who passed the screening for the first time,the number of newborns who passed the compound sieve and the number of newborns who passed the examination in the hearing diagnosis center were less than those in the normal newborns.In the newborns with elderly mother,the number of newborns who passed the screening for the first time and the number of newborns who passed the compound sieve were less than those in the newborns with young mothers.The differences above were all statistically significant(P<0.001).Conclusion:Clinicians shall strengthen the screening and management for the newborns,especially high risk newborns,newborns with older mothers and cesarean section newborns.For the newborns who don’t pass the screening for the first time and newborns with high risk factors,we shall strengthen the follow-up and give them regular check in order to confirm the diagnosis as soon as possible and reduce the incidence of hearing impairment.%目的：探讨新生儿听力筛查在新生儿听力疾病诊断中的临床意义。方法：选择2013年6月-2015年3月于本院住院分娩的4085例新生儿作为研究对象，均采用自动听性脑干反应（AABR）进行听力筛查，分析新生儿中不同分娩方式、高危儿（早产儿、高胆红素血症、窒息）、产妇年龄、性别因素对筛查结果的影响。结果：4085例新生儿均于出生后2~5 d内完成ABBR筛查，其中首次筛查通过3423例，占比83.8%，未通过筛查662例，占比16.2%，复筛时通过606例，占比14.8%，未通过56例，占比1.4%，复筛未通过的新生儿经本院新生儿听力诊断中心确诊为听力障碍18例，占比0.44%；自然分娩新生儿首次筛查通过例数显著多余剖宫产新生儿；高危新生儿首次筛查、复筛及听力诊断中心检查通过例数均少于正常新生儿；高龄产妇新生儿的首次筛查、复筛通过例数均低于非高龄产妇新生儿，以上比较差异均有统计学意义（P<0.001）。结论：临床医师应加强对新生儿尤其是高危新生儿、高龄产妇、剖宫产新生儿的筛查及管理，对首次筛查未通过及具有高危因素的新生儿应加强随访，定期检查，尽早明确诊断，降低听力障碍的发生率。