TEOAE与ABR联合应用于新生儿听力筛查的临床观察与分析(1)
【摘要】 目的：探讨瞬态诱发性耳声发射(transient evoked otoacoustic emission，TEOAE)和听觉脑干反应(auditory brainstem response，ABR)联合应用于新生儿听力筛查中的临床观察与分析。方法：汕头大学医学院附属粤北医院出生2～5 d的2528例(5056耳)新生儿应用TEOAE初筛，未通过者于生后42 d应用TEOAE和ABR联合复筛；复筛未通过者3个月龄行TEOAE、ABR、声导抗测听等检查并综合评估听觉。结果：新生儿听力初筛中共有2299例通过(90.94%)，229例(9.06%)未通过，需复筛229例，实际复筛159例，复筛率69.43%，复筛通过150例(94.33%)，未通过9例(5.67%)，复筛未通过患儿检出听力损失5例(1.98‰)。结论：新生儿进行听力筛查时，初筛应用TEOAE，复筛应用TEOAE和ABR联合筛查方案可有效减少漏诊和误诊。
【关键词】 TEOAE； ABR； 新生儿； 听力筛查
, 百拇医药
中图分类号 R764 文献标识码 A 文章编号 1674-6805(2014)30-0010-03
Clinical Analysis of Combined Use of TEOAE and ABR in Hearing Screening of Newborns/LI Yu-jie，ZHOU Wen-fang，CHEN Zhi-xi，et al.//Chinese and Foreign Medical Research，2014，12(30)：10-12
【Abstract】 Objective：To investigate the clinical significance of combined use of TEOAE and ABR testing in hearing screening in newborns.Method：2528(5056 ears) newborns in the affiliated Yuebei People’s Hospital of Shantou University Medical College were received initial hearing screening using TEOAE after 2-5 days of birth.The infants who failed it were checked by combined use of TEOAE and ABR after 42 days of birth.follow-up and relevent assessment of the hearing were provided continually for those who failed both tests after 3 months of birth.Result：Out of 2528 infants，2299(90.94%) passed and 229(9.06%) failed first screening.229 newborns needed screening again，however only 159(69.43%) accepted rescreeening，of whom 150(94.33%) passed and 9(5.67%) failed.5(1.98%) infants were diagnosed as hearing loss after assessment of the hearing.Conclusion：In the screening program，TEOAE should be used for the initial screening and the combined use of TEOAE and ABR for the rescreening to ensure the accurate detection rate of deafness in newborns for less misdiagnosis.
, 百拇医药
【Key words】 Transient evoked otoacoustic emission； Auditory brainstem response； Newborns； Hearing screening
First-author’s address：Affiliated Yuebei People’s Hospital，Shantou University Medical College，Shaoguan 512026，China
听力障碍是出生缺陷中最常见的。婴幼儿听力损失直接影响其语言的形成，严重者甚至可以导致聋哑；同时语言发育的滞后还可影响儿童心理、智力和社会交往能力的发展。国外研究表明：新生儿听力障碍的发生率为1‰～3‰，国内流行病学资料显示，新生儿听力损失率为1‰～2‰，我国每年出生2千万人口，年有(2～6)万聋儿出生，如不能早期发现和预防，将给家庭、社会带来沉重负担。所以开展新生儿听力筛查越来越受到重视，它能最大限度地早发现听力障碍患儿，防止错过干预治疗的最佳时机[1]。因此早期听力检测及干预至关重要，而如何提高筛查质量，降低假阴、阳性率是其核心。笔者所在医院2007年起应用TEOAE联合ABR对住院新生儿行听力筛查，现报道如下。
1 资料与方法
1.1 一般资料
2011年2月-2013年6月笔者所在医院产科、新生儿科及NICU住院的新生儿2638例(5276耳)中2528例(5056耳)应用TEOAE初筛，未通过的229例(458耳)应用TEOAE和ABR联合复筛。其中男1359例(2718耳)、女1169例(2338耳)；正常足月儿2106例、早产儿242例、窒息缺氧98例、高胆红素血症78例、先天性畸形4例(2例单耳先天性耳畸形并外耳道闭锁，2例唇裂)。, http://www.100md.com(李昱颉 周文芳 陈志喜 刘娜秀 罗许勇 张金平 熊奇斌)
【关键词】 TEOAE； ABR； 新生儿； 听力筛查
, 百拇医药
中图分类号 R764 文献标识码 A 文章编号 1674-6805(2014)30-0010-03
Clinical Analysis of Combined Use of TEOAE and ABR in Hearing Screening of Newborns/LI Yu-jie，ZHOU Wen-fang，CHEN Zhi-xi，et al.//Chinese and Foreign Medical Research，2014，12(30)：10-12
【Abstract】 Objective：To investigate the clinical significance of combined use of TEOAE and ABR testing in hearing screening in newborns.Method：2528(5056 ears) newborns in the affiliated Yuebei People’s Hospital of Shantou University Medical College were received initial hearing screening using TEOAE after 2-5 days of birth.The infants who failed it were checked by combined use of TEOAE and ABR after 42 days of birth.follow-up and relevent assessment of the hearing were provided continually for those who failed both tests after 3 months of birth.Result：Out of 2528 infants，2299(90.94%) passed and 229(9.06%) failed first screening.229 newborns needed screening again，however only 159(69.43%) accepted rescreeening，of whom 150(94.33%) passed and 9(5.67%) failed.5(1.98%) infants were diagnosed as hearing loss after assessment of the hearing.Conclusion：In the screening program，TEOAE should be used for the initial screening and the combined use of TEOAE and ABR for the rescreening to ensure the accurate detection rate of deafness in newborns for less misdiagnosis.
, 百拇医药
【Key words】 Transient evoked otoacoustic emission； Auditory brainstem response； Newborns； Hearing screening
First-author’s address：Affiliated Yuebei People’s Hospital，Shantou University Medical College，Shaoguan 512026，China
听力障碍是出生缺陷中最常见的。婴幼儿听力损失直接影响其语言的形成，严重者甚至可以导致聋哑；同时语言发育的滞后还可影响儿童心理、智力和社会交往能力的发展。国外研究表明：新生儿听力障碍的发生率为1‰～3‰，国内流行病学资料显示，新生儿听力损失率为1‰～2‰，我国每年出生2千万人口，年有(2～6)万聋儿出生，如不能早期发现和预防，将给家庭、社会带来沉重负担。所以开展新生儿听力筛查越来越受到重视，它能最大限度地早发现听力障碍患儿，防止错过干预治疗的最佳时机[1]。因此早期听力检测及干预至关重要，而如何提高筛查质量，降低假阴、阳性率是其核心。笔者所在医院2007年起应用TEOAE联合ABR对住院新生儿行听力筛查，现报道如下。
1 资料与方法
1.1 一般资料
2011年2月-2013年6月笔者所在医院产科、新生儿科及NICU住院的新生儿2638例(5276耳)中2528例(5056耳)应用TEOAE初筛，未通过的229例(458耳)应用TEOAE和ABR联合复筛。其中男1359例(2718耳)、女1169例(2338耳)；正常足月儿2106例、早产儿242例、窒息缺氧98例、高胆红素血症78例、先天性畸形4例(2例单耳先天性耳畸形并外耳道闭锁，2例唇裂)。, http://www.100md.com(李昱颉 周文芳 陈志喜 刘娜秀 罗许勇 张金平 熊奇斌)