论文部分内容阅读
目的探讨新生儿听力筛查中漏诊因素,以提高新生儿听力障碍的确诊率。方法用丹麦M adsen公司生产的Accuscreen听力筛查仪对出生后48~72小时内的新生儿进行瞬态声诱发耳声发射(TEOAE)检查;对出现异常者分别于1个月、2个月、3个月内进行复查,并应用快速脑干诱发电位听力筛查仪(AABR)进行初步诊断;于出生后6个月再次进行TEOAE及AABR检测,结果异常者最后确诊;运用本院儿童和孕产妇管理系统,对初筛对象2864例,分别于1个月、2个月、3个月,全部进行家庭随访,共3次,在随访中,无论TEOAE是否通过,只要小儿对声音反应异常,均应用AABR进行检测,校对检查结果。结果2864例新生儿中,用TEOAE进行初筛,184例异常,异常率6.42%(184/2864);对184例初筛异常患者进行AABR检测,6例异常,被最后确诊;1例初筛时TEOAE通过而经AABR检测异常,最后确诊。结论单纯应用TEOAE对新生儿听力筛查简便、快速、经济,但可产生漏诊现象。对生后3个月内的婴幼儿,如发现听觉有异常表现,即使TEOAE检测通过,也要用AABR确诊检测,以便做到早发现、早干预。
Objective To investigate the missed diagnosis factors in newborn hearing screening to improve the diagnosis rate of neonatal hearing impairment. Methods A transient acoustic evoked otoacoustic emission (TEOAE) examination was performed in neonates aged 48-72 hours after birth with the Accuscreen audiometer from M adsen, Denmark. The patients with abnormalities were examined at 1 month, 2 months , 3 months to review, and the application of rapid brainstem response potential audiometry (AABR) for initial diagnosis; 6 months after birth again TEOAE and AABR test, the results of the final diagnosis of abnormal; use of our hospital and children Maternal management system, the initial screening of 2864 patients, respectively, in 1 month, 2 months, 3 months, all the family follow-up, a total of 3 times, at follow-up, regardless of whether TEOAE passed, as long as children respond to the sound abnormal , Are used AABR test, proofread the test results. Results Among the 2864 neonates, 184 were abnormal with an abnormality rate of 6.42% (184/2864) with TEOAE. AABR was detected in 184 patients with abnormal primary screening, 6 were abnormal, and were finally diagnosed. One patient was initially screened When TEOAE passed AABR abnormalities, the final diagnosis. Conclusion The simple application of TEOAE for neonatal hearing screening is quick, easy and economical, but it can cause missed diagnosis. In 3 months after birth infants and young children, if found abnormal hearing, even if the TEOAE test passed, but also with AABR diagnosis test, in order to achieve early detection and early intervention.