2015-2016年济宁市新生儿听力筛查结果分析

发布时间：2018-03-31 18:20

  本文选题：新生儿　切入点：听力筛查　出处：《青岛大学》2017年硕士论文

【摘要】：目的:通过调查2015.1.1-2016.12.31济宁市各区县市接生医院出生的新生儿听力筛查现状及筛查结果,以了解济宁市新生儿听力筛查通过率及先天性听力受损发生率。通过比较不同胎龄早产儿与正常新生儿听力筛查结果以及听力损伤的发病率,分析其听力损伤情况,以便及早对患有听力障碍的新生儿进行对症干预治疗,以减少听损对新生儿成长和发育产生的影响。方法:(1)以2015.1.1-2016.12.31所有在济宁市各区县市接生医院出生的新生儿为研究对象,包括常住人口及流动人口(2015年共829.92万,2016年共835.44万),分析并计算济宁市新生儿听力筛查通过率及先天性听力受损发生率。(2)选取2015.1.1-2016.12.31年入住济宁市泗水县人民医院新生儿科的新生儿为研究对象,并根据胎龄将其分为早期早产儿、中期早产儿、晚期早产儿和足月儿共4组。使用瞬态诱发耳声发射(TEOAE)进行初筛(生后3-5天)和复筛(初筛未通过30-42天),对复筛未通过者于3月龄行自动脑干听觉诱发电位(ABR)检测确诊先天性听力受损,比较各组听力筛查未通过率的差异。结果:(1)2015.1.1-2015.12.31济宁市新生儿初筛通过率94.23%,复筛通过率为89.20%,听损发生率3.25‰,中重度以上听损发生率0.43‰;2016.1.1-2016.12.31济宁市新生儿初筛通过率93.72%,复筛通过率为88.19%,听损发生率4.11‰,中重度以上听损发生率0.94‰。(2)选取2015年1月1日-2016年12月31日入住济宁市泗水县人民医院新生儿科行听力筛查的822例新生儿,根据早产儿胎龄分为:(1)早期:胎龄32周;(2)中期:34周胎龄≥32周;(3)晚期:37周胎龄≥34周;(4)足月儿:≥37周,各组总人数分别54例、108例、220例、440例。初筛结果:四组未通过率分别为90.7%、82.4%、54.5%、49.3%,各组之间的未通过率比较差异有统计学意义(P0.05);复筛结果四组未通过率分别为分别有47.6%、24.5%、12.8%、8.2%,各组未通过率比较差异有统计学意义(P0.05);ABR检查结果:四组未通过率分别为分别有25.0%、8.9%、4.9%、2.9%,四组未通过率逐渐减低,各组未通过率比较差异有统计学意义(P0.05)。结论:1.2015和2016年两年济宁市新生儿听力筛查综合覆盖率达到96.02%,新生儿OAE初筛、复筛及ABR筛查结果中未通过率有升高的趋势,可能与检测手段提高、出生人口数升高等原因有关,采用耳声发射和脑干听觉诱发电位结合的诊断方式增加了检出率,说明联合检测的手段是目前最合适的新生儿听力筛查方法。2.不同胎龄的新生儿听力损伤发生率有所不同,胎龄越小听力损伤发生的危险性越高,采用瞬态耳声发射和脑干听觉诱发电位结合的诊断方式,可以更加及时的明确诊断,因此早产儿生后及早进行听力筛查,可以早期对听力损伤的新生儿进行早期干预,预防后期并发症。
[Abstract]:Objective: to investigate the present situation and results of hearing screening of newborns born in the district and county delivery hospitals of Jining, January 1, 2011 to December 31, 2011. In order to understand the pass rate of neonatal hearing screening and the incidence of congenital hearing impairment in Jining, the hearing screening results of premature infants and normal newborns of different gestational ages and the incidence of hearing loss were compared, and the hearing impairment was analyzed. In order to treat the newborns with hearing impairment as early as possible and reduce the influence of hearing loss on the growth and development of newborns, methods: take all the newborns born in the district and county delivery hospital of Jining city as the research object from January 1 to December 31, 2016.31. Including resident population and floating population (8.2992 million in 2015 and 8.3544 million in 2016, the pass rate of neonatal hearing screening and the incidence of congenital hearing impairment in Jining City are analyzed and calculated.) freshmen admitted to the people's Hospital of Sisui County in Jining City from January to December 31, 2015.2016.31. Pediatric newborns were the subjects of the study. And according to the gestational age, they are divided into early preterm infants, intermediate premature infants, Four groups of late premature infants and full-term infants were examined with transient evoked otoacoustic emission (TEOAE) for primary screening (3-5 days after birth) and double sieve (primary screen failed for 30-42 days) and automatic brainstem auditory evoked potential (ABR) for those who failed to pass the screening at 3 months of age. The diagnosis of congenital hearing loss, Results the primary screening pass rate of newborns in Jining City from January 1 to December 31, 2011 was 94.233.The pass rate of repeated screening was 89.20%, and the rate of hearing loss was 3.25 鈥，

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