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目的 了解先天性听力障碍在高危新生儿中的发病率以及可能导致听力障碍的高危因素。方法 采用两阶段的筛查方案,即出生后以耳声发射(OAE)进行初筛,初检时间不固定;出生42 d左右,以OAE复筛,未通过者用听性脑干诱发电位(ABR)予以确诊。结果 共筛查高危新生儿208例,男性130例,占62.5％;女性78例,占37.5％。初检和复检率分别为100％和82.96％。初检结果阳性有72例,阳性率为34.61％;复检结果阳性的8例,阳性率为7.14％。最终前来诊的病人有6例,确诊有听力障碍的2例。高危新生儿中听力障碍的发病率约为1.78％。结论 对高危儿进行听力筛查,初检时间最好选择在病情稳定、出院前进行。如果条件允许,能进行42 d左右时的复筛,则可降低假阳性与正常儿童不同的是高危儿童即使通过筛查,也建议其定期复查。所以,高危新生儿需另行建立一个详细的追踪随访体系,以便能随时与家长保持联系,及时了解孩子生长发育情况。另外,必须详尽地向家长解释筛查的结果和意义,让他们了解疾病可能对其孩子造成的影响及复查的必要性。
Objective To understand the prevalence of congenital hearing impairment in high-risk newborns and the possible risk factors for hearing impairment. Methods A two-stage screening scheme was adopted. The primary screening was performed with otoacoustic emission (OAE) at birth, and the initial examination time was not fixed. About 42 days after birth, the patients were screened by OAE, ABR) to be diagnosed. Results A total of 208 high-risk neonates were screened, 130 males (62.5%) and 78 females (37.5%). The initial examination and re-examination rates were 100% and 82.96% respectively. The first positive result was 72 cases, the positive rate was 34.61%; retest results in 8 cases, the positive rate was 7.14%. Six patients eventually came to the clinic and two were diagnosed with hearing impairment. The incidence of hearing-impaired children in high-risk neonates is about 1.78%. Conclusion Hearing screening of high-risk children, the best initial screening time in the stable condition, discharged before discharge. If the conditions allow, can carry out about 42 d when the screen, you can reduce the false positive and normal children is different even if high-risk children through screening, it is also recommended regular review. Therefore, high-risk newborns need to establish a separate follow-up tracking system in order to be able to keep in touch with parents, keep abreast of growth and development of children. In addition, the results and the significance of the screening must be explained in detail to parents so that they may understand the effects the disease may have on their children and the need for a review.