东莞地区新生儿听力筛查的多中心研究

Multicenter study of neonatal hearing screening in Dongguang region

摘要:

目的：探索适合于新生儿听力筛查的临床策略,通过多中心合作获得新生儿听力损失发病的基本资料。方法：应用畸变产物耳声发射技术(DPOAE)进行听力普遍筛查。对复筛未通过者,于生后3个月左右采用听性脑干反应(ABR)和40Hz听性相关电位(40HzAERP)技术诊断。结果：该研究实际筛查17360例,筛查率为89.1%。初筛通过15624例(90.0%)。需复筛的1736例,实际复筛1597例,复筛率92%,复筛通过1491例,复筛通过率93.4%。41例复查ABR其中确诊新生儿先天性听力损失39例,减去2例假阳性,该组新生儿先天性听力损失的发生率为2.25‰。结论：新生儿听力普查十分必要。DPOAE是一种快速行之有效的新生儿听力初筛方法,两步筛查法可及早发现听力损失,听力筛查、诊断、康复统筹运作是使聋儿得以康复的重要保证。

Abstract:

Objective This study performed multicenter neonatal hearing screening in the Dongguang region so as to explore the model of neonatal hearing screening suitable for this region.Methods The study population consisted of 17 360 infants from 6 hospitals of Dongguang region. Universal hearing screenings by distortion product otoacoustic emission (DPOAE) techniques were done within 24- 48 hrs after birth. Infants who failed the initial screening test underwent second screening by DPOAE one month later. Acoustic brain-stem response (ABR) and 40 Hz auditory event related potential (40Hz-AERP)techniques were used to examine the hearing of those who failed the second hearing screening test at age of 3 months.Results Of the 17 360 infants, 15 624(89.1%)passed the initial screening. A total of 1 736 cases needed a second screening test. One thousand five hundred and ninety seven infants underwent the second test. Among the 1 597 cases, 1 491(93.4%) passed the second screening. Ultimately 39 cases were diagnosed with congenital hearing loss, with an incidence of hearing loss of 2.25‰.Conclusions DPOAE can be used as a rapid and effective method for initial hearing screening in infants. The two-stage hearing screening test can identify hearing loss early.