正常出生新生儿瞬态诱发耳声发射与畸变产物耳声发射听力筛查结果比较

发布时间：2018-06-17 14:59

本文选题：新生儿 + 听力筛查　；参考：《听力学及言语疾病杂志》2017年03期

【摘要】：目的探讨瞬态诱发耳声发射(transient evoked otoacoustic emissions,TEOAE)和畸变产物耳声发射(distortion products otoacoustic emissions,DPOAE)用于新生儿听力筛查特点,为正常出生新生儿听力筛查方法的选择提供参考。方法于出生后48~72小时,对1 062例正常出生的新生儿分别使用TEOAE和DPOAE进行听力初筛,其中135例未通过初筛者,在42天龄左右,同时进行TEOAE和DPOAE复筛;复筛未通过者3月龄左右进行诊断型听性脑干反应测试。结果1 062例新生儿中TEOAE初筛未通过率为11.02%(117/1 062),DPOAE未通过率为13.65%(145/1 062);135例进行了复筛,TEOAE和DPOAE未通过率分别为17.78%(24/135)和20.74%(28/135),DPOAE初、复筛未通过率均高于TEOAE,差异均有统计学意义(P0.001);TEOAE和DPOAE在初筛和复筛中的一致率分别为96.04%和95.56%,kappa值分别为0.817和0.857。在初筛中TEOAE每耳的平均测试时间为24±25s,DPOAE为40±34s;在复筛中TEOAE为52±41s,DPOAE为73±62s,配对样本t检验显示两种方法的测试时间差异有统计学意义(P=0.000)。复筛的135例中,共有7例(10耳)最终被诊断为不同程度的传导性听力损失(9耳)及感音神经性听力损失(1耳),这10耳TEOAE和DPOAE初、复筛均未通过。结论作为正常出生新生儿的听力筛查方法,TEOAE较DPOAE未通过率低,耗时少;作为新生儿听力筛查工具,TEOAE可能比DPOAE有优势。
[Abstract]:Objective to investigate the characteristics of transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emission (DPOAE) in neonatal hearing screening, and to provide a reference for the selection of hearing screening methods for normal newborns. Methods 1 062 newborns with normal birth were screened with TEOAE and DPOAE at 48h for 72 hours after birth. 135 of them who failed the first screening were screened by TEOAE and DPOAE at the age of 42 days at the same time. The diagnostic auditory brainstem response was tested at 3 months of age. Results in 1 062 newborns, the unpass rate of TEOAE screening was 11.02and the unpass rate of DPOAE was 13.6565 / 1062 / 1062. The unpass rates of TEOAE and DPOAE were 17.7824 / 135 and 20.74AE / 28135 / DPOE, respectively. The unpass rate of double screen was higher than that of TEOAE, and the difference was statistically significant (P 0.001). The consistent rates of TEOAE and DPOAE were 96.04% and 95.56kappa, 0.817 and 0.857, respectively. The average test time per ear of TEOAE was 24 卤25sg DPOAE (40 卤34s) in primary screen and 52 卤41sd DPOAE (73 卤62s) in double sieve. The difference of test time between the two methods was statistically significant (P = 0.000). Among 135 cases, 7 cases (10 ears) were finally diagnosed as conductive hearing loss (9 ears) and sensorineural hearing loss (1 ear). Both TEOAE and DPOAE were not passed. Conclusion as a method of hearing screening for normal newborns, TEOAE has lower pass rate and less time consuming than DPOAE, and it may be superior to DPOAE as a hearing screening tool for newborns.
【作者单位】：中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科;
【基金】：公益性卫生行业科研专项项目(201202005) 国家科技部“十二·五”支撑项目(2012BAI12B00) 国家临床重点专科基金资助
【分类号】：R764

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