中华耳科学杂志
中華耳科學雜誌
중화이과학잡지
CHINESE JOURNAL OF OTOLOGY
2013年
2期
235-238
,共4页
瞬态诱发耳声发射%自动听性脑干反应%高危新生儿听力筛查
瞬態誘髮耳聲髮射%自動聽性腦榦反應%高危新生兒聽力篩查
순태유발이성발사%자동은성뇌간반응%고위신생인은력사사
Transient evoked otoacoustic emission(TEOAE)%Automated auditory brainstem response (AABR)%High-risk Newborn hearing screening
目的探讨联合应用瞬态诱发性耳声发射(TEOAE)和自动听性脑干反应(AABR)在高危新生儿听力筛查中的应用。方法对新生儿科NICU高危新生儿200例（400耳），运用AccuScreen听力筛查仪，同时进行TEOAE和AABR联合听力筛查，根据TEOAE初次筛查结果通过与否，分为双耳TEOAE初筛均未通过组(A组)和双耳TEOAE初筛均通过组（B组），共2组，每组100例（200耳），其中3个月时任何一项检查未通过者均在患儿6个月时进行听性脑干反应、声导抗测试等诊断性检查。结果A组：3个月时TEOAE未通过12例（22耳），AABR未通过2例（2耳），联合筛查未通过22例。6月龄时确诊1例（2耳）分泌性中耳炎，该两耳均为3次TEOAE筛查未通过、AABR筛查通过者，本组高危新生儿听力损伤现患率为1.7%（2/120）；B组：3个月时TEOAE未通过2例（2耳），AABR未通过5例（5耳），联合筛查未通过5例（5耳）。6月龄时确诊2例（2耳）诊断为蜗后性耳聋，该两耳均为3次AABR筛查未通过、TEOAE筛查通过者，本组高危新生儿听力损伤现患率为1.4%（2/146）,每组在定期复筛时均有部分失诊患儿。结论通过TEOAE和AABR联合筛查，可以检出中耳、蜗性及蜗后听损伤，证实了TEOAE和AABR是听力筛查的有效组合方式，AABR和TEOAE联合筛查应用可以优势互补，降低漏诊、误诊率。
目的探討聯閤應用瞬態誘髮性耳聲髮射(TEOAE)和自動聽性腦榦反應(AABR)在高危新生兒聽力篩查中的應用。方法對新生兒科NICU高危新生兒200例（400耳），運用AccuScreen聽力篩查儀，同時進行TEOAE和AABR聯閤聽力篩查，根據TEOAE初次篩查結果通過與否，分為雙耳TEOAE初篩均未通過組(A組)和雙耳TEOAE初篩均通過組（B組），共2組，每組100例（200耳），其中3箇月時任何一項檢查未通過者均在患兒6箇月時進行聽性腦榦反應、聲導抗測試等診斷性檢查。結果A組：3箇月時TEOAE未通過12例（22耳），AABR未通過2例（2耳），聯閤篩查未通過22例。6月齡時確診1例（2耳）分泌性中耳炎，該兩耳均為3次TEOAE篩查未通過、AABR篩查通過者，本組高危新生兒聽力損傷現患率為1.7%（2/120）；B組：3箇月時TEOAE未通過2例（2耳），AABR未通過5例（5耳），聯閤篩查未通過5例（5耳）。6月齡時確診2例（2耳）診斷為蝸後性耳聾，該兩耳均為3次AABR篩查未通過、TEOAE篩查通過者，本組高危新生兒聽力損傷現患率為1.4%（2/146）,每組在定期複篩時均有部分失診患兒。結論通過TEOAE和AABR聯閤篩查，可以檢齣中耳、蝸性及蝸後聽損傷，證實瞭TEOAE和AABR是聽力篩查的有效組閤方式，AABR和TEOAE聯閤篩查應用可以優勢互補，降低漏診、誤診率。
목적탐토연합응용순태유발성이성발사(TEOAE)화자동은성뇌간반응(AABR)재고위신생인은력사사중적응용。방법대신생인과NICU고위신생인200례（400이），운용AccuScreen은력사사의，동시진행TEOAE화AABR연합은력사사，근거TEOAE초차사사결과통과여부，분위쌍이TEOAE초사균미통과조(A조)화쌍이TEOAE초사균통과조（B조），공2조，매조100례（200이），기중3개월시임하일항검사미통과자균재환인6개월시진행은성뇌간반응、성도항측시등진단성검사。결과A조：3개월시TEOAE미통과12례（22이），AABR미통과2례（2이），연합사사미통과22례。6월령시학진1례（2이）분비성중이염，해량이균위3차TEOAE사사미통과、AABR사사통과자，본조고위신생인은력손상현환솔위1.7%（2/120）；B조：3개월시TEOAE미통과2례（2이），AABR미통과5례（5이），연합사사미통과5례（5이）。6월령시학진2례（2이）진단위와후성이롱，해량이균위3차AABR사사미통과、TEOAE사사통과자，본조고위신생인은력손상현환솔위1.4%（2/146）,매조재정기복사시균유부분실진환인。결론통과TEOAE화AABR연합사사，가이검출중이、와성급와후은손상，증실료TEOAE화AABR시은력사사적유효조합방식，AABR화TEOAE연합사사응용가이우세호보，강저루진、오진솔。
Objective To investigate the clinical value of combined use of TEOAE and AABR testing in hearing screen-ing in high-risk newborns in NICU. Methods Two hundred high-risk newborns (400 ears) in the NICU received TEOAE/AABR screening with an AccuScreen. At least one ear failed initial TEOAE screening in 100 children (Group A), while both ears passed initial TEOAE screening in the rest 100 children (Group B). At repeat screening at 3rd month of age, those failing again were subjected to ABR and audiology test battery at 6th month of age.Result In Group A, 12 children (22 ears) failed TEOAE and 2 (2 ears) failed AABR at 3rd month, and a total of 12 children (22 ears) failed combined TEOAE/AABR screen-ing. Of these children, 1 (2 ears) was diagnosed with secretory otitis media at 6th month of age. Both ears in this patient failed TEOAE but passed AABR at all three screening time points. Incidence of hearing impairment was 0.5%(1/100) in this group. In Group B, 2 children (2 ears) failed TEOAE and 5 (5 ears) failed AABR screening at 3rd month, with a total of 5 children (5 ears) failing the combined TEOAE/AABR screening. Two children (2 ears) in this group were diagnosed with auditory neuropa-thy at 6th month of age. Both ears failed AABR but passed TEOAE at all three screening time points. Incidence of hearing im-pairment was 2% (2/100) in this group. Some patients were lost to follow up in both groups. Conclusion Combined use of TEOAE and AABR can effectively detect hearing impairment caused by middle ear, cochlear or retrocochlear disorders. Their complementary use can improve the accuracy of hearing screening, and reduce the chance of misdiagnose or missed diagnose.
