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目的探讨听力筛查未通过婴幼儿的听力学特点及原因。方法应用听性脑干反应(auditory brainstem response,ABR)、40Hz听觉相关电位(40 Hz auditory event related potential,40 Hz AERP)、畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)、鼓室声导抗及声反射方法,对126例听力筛查未通过的婴幼儿进行听力学诊断性检查,确认听力损失的程度及性质,并对听力损失婴幼儿的原因进行分析。结果126例(252耳)婴幼儿中,感音神经性聋61例(48.41%),传导性聋48例(38.09%),ABR反应阈值正常范围17例(13.50%)。此组患儿既往病史有母孕期感染病史21例、先兆流产9例、高龄6例、延期妊娠7例、伴全身系统疾病10例;新生儿期黄疸13例、缺氧窒息18例、早产儿及低体重8例、伴其他新生儿疾病8例、有听力损失家族史5例,颅面畸形3例,中枢神经系统疾病6例,第2胎9例。结论听力筛查未通过的婴幼儿听力评估后有不同的表现,本组感音神经性聋较传导性聋所占比例高,多数听力损失患儿伴有高危因素。
Objective To investigate the audiological features and causes of hearing screening failure in infants and toddlers. Methods The auditory brainstem response (ABR), 40 Hz auditory event related potential (40 Hz AERP), distortion product otoacoustic emissions (DPOAE), tympanometry And acoustic reflex method, 126 cases of hearing screening did not pass audiology diagnostic tests to confirm the degree and nature of hearing loss, and hearing loss of infants and young children were analyzed. Results Among the 126 infants (252 ears), 61 (48.41%) had sensorineural deafness, 48 (38.09%) had conductive deafness and 17 (13.50%) had normal ABR threshold. The past history of this group of children with a history of maternal infection in 21 cases, threatened abortion in 9 cases, 6 cases of advanced, delayed pregnancy in 7 cases, with systemic diseases in 10 cases; neonatal jaundice in 13 cases, hypoxia asphyxia in 18 cases, premature children 8 cases with low body weight, 8 cases with other newborn diseases, 5 cases with family history of hearing loss, 3 cases with craniofacial deformity, 6 cases with central nervous system diseases and 9 cases with 2 cases. Conclusion There are different manifestations of hearing impairment in infants and young children who have not passed hearing screening. The proportion of sensorineural deafness is higher than that of conductive deafness, and most children with hearing loss have high risk factors.