1 242 例新生儿听力筛查结果分析孔祥苓 1 ，王赏 2 ，梅文华 11. 河北医科大学第一医院耳鼻咽喉科 河北 石家庄 050031;2. 河北医科大学第一医院护理部，河北 石家庄 050031基金项目:河北省科学技术项目 (112761137)摘 要:目的 分析新生儿听力筛查结果及相关影响因素。方法 回顾性分析 2013 年 6 月 －2014 年 6 月出生的 1 242 例新生儿，根据新生儿高危诊断标准将新生儿分为正常组 807 例和高危组 435 例，应用畸变产物耳声发射 (DPOAE)和听觉诱发电位 (ABＲ)进行初步筛查和复查并进行听力障碍诊断，对可能影响听力损伤的相关因素进行分析。结果 新生儿听力筛查率为99. 20% (1 242/1 252)，初筛通过率为 98. 55% (1 224/1 242)，复查率为 90. 02% (1 118/1 242)，复查通过率为 60. 02% (671/1 118);不同程度听力损伤的发生率为 5. 59% (25/447)。正常组的初筛通过率为 99. 75% (805/807)与高危组的 96. 32%(419/435)差异无统计学意义 (P＞0. 05);而正常组复查通过率为 78. 31% (632/807)明显高于高危组的 8. 97% (39/435)，差异有统计学意义 (P＜0. 01);高危组新生儿听力损伤发生率为 3. 91% (17/435)显著高于正常组的 0. 99% (8/807)，差异有统计学意义 (P＜0. 05)。新生儿性别与听力损伤率之间的差异无统计学意义 (P＞0. 05)，而胎龄、分娩方式、出生体质量及患病情况与听力损伤率之间的差异具有统计学意义 (P＜0. 05)。结论 新生儿中有较高比例的听力损伤，早产儿、剖宫产儿、低出生体质量新生儿及合并患有其他疾病的新生儿的听力更容易受到损伤。临床上应对所有听力损伤的婴儿进行针对性治疗，以保证其身体健康。关键词:新生儿;听力筛查;影响因素中国图书分类号:Ｒ174 文献标识码:A 文章编号:1001-4411(2016)14-2870-03;doi:10. 7620/zgfybj. j. issn. 1001－4411. 2016. 14. 39Analysis on the results of neonatal hearing screening among 1 242 newbornsKONG Xiang－Ling，WANG Shang，MEI Wen－Hua.Department of Otorhinolaryngology，the First Hospital of Hebei Medical University，Shijiazhuang，Hebei 050031，ChinaAbstract:Objective To analyze neonatal hearing screening results and the related influencing factors. Methods A total of 1 242neonates born from June 2013 to June 2014 were analyzed retrospectively，then they were divided into normal group (807 neonates)andhigh－risk group (435 neonates)according to high－risk neonatal diagnostic criteria. Distortion product otoacoustic emission (DPOAE)andauditory evoked potential (ABＲ)were used for primary screening and secondary screening，the related influencing factors of hearing impair-ment were analyzed. Ｒesults The neonatal hearing screening rate was 99. 20% (1 242/1 252). The pass rate of primary screening was98. 55% (1 224/1 242)，the secondary screening rate was 90. 02% (1 118/1 242)，the pass rate of secondary screening was 60. 02%(671/1 118);the incidence rate of hearing impairment to different degrees was 5. 59% (25/447). The pass rates of primary screening innormal group and high－risk group were 99. 75% (805/807)and 96. 32% (419/435)，respectively，there was no statistically significantdifference (P＞0. 05);the pass rate of secondary screening in normal group was 78. 31% (632/807)，which was statistically significantlyhigher than that in high－risk group (8. 97%，39/435)(P＜0. 01);the incidence rate of hearing impairment in high－risk group was 3. 91%(17/435)，which was statistically significantly higher than that in normal group (0. 99%，8/807)(P＜0. 05). There was no statisticallysignificant difference in the incidence rate of hearing impairment between boys and girls (P＞0. 05)，but there were statistically significantdifferences among the neonates with different fetal age，delivery modes，birth weights，and sickness statuses (P＜0. 05). Conclusion Theincidence rate of hearing impairment is high among neonates，especially among premature infants，neonates born after cesarean section，lowbirth weight infants，and the neonates with other diseases. All the neonates with hearing impairment should be treated correspondingly to en-sure their health.Key words:Neonate;Hearing screening;Influencing factor听力障碍是临床上常见的先天性出生缺陷，在新生儿中的发生率为 0. 1% ～0. 3%，远高于其他新生儿疾。1］ 。患有听力障碍新生儿的语言功能受到严重影响，给新生儿及其家庭带来沉重的心理负：途酶旱，因此进行新生儿听力筛查具有重要作用 ［2］ 。新生儿听力筛查是使用简单有效的方法测试新生儿的听力，其具有快捷、无创伤等特点，随着听力筛查在我国的广泛引用，目前已成为发现先天性听力障碍的方法之一［3］ 。新生儿听力障碍的治疗秉持“早发现，早治疗”的原则，发现后进行针对性有效治疗，可以降低新生儿的残疾率，提高新生儿的听力和语言功能 ［4］ 。本研究通过对 1 242 例新生儿听力筛查结果进行分析，探讨影响新生儿听力障碍的因素，现报道如下。1 资料与方法1. 1 临床资料 回顾性分析 2013 年 6 月 －2014 年 6月河北医科大学第一医院产科出生的新生儿 1 242例，其中男 613 例，女 629 例;胎龄 33 ～ 42 周，平· 0 7 8 2 · 中国妇幼保健 2016 年 7 月第 31 卷第 14 期 Maternal and Child Health Care of China. July 2016，Vol. 31，No. 14
