Srisuparp Pimol, Gleebbur Ruemporn, Ngerncham Sopapan, Chonpracha Jintana, Singkampong Jeeranan
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University.
J Med Assoc Thai. 2005 Nov;88 Suppl 8:S176-82.
To determine the prevalence and significant risk factors for pathologic hearing screening test results in high-risk neonates and the feasibility of implementing hearing screening program using automated otoacoustic emission (OAE)/ auditory brain stem response (ABR) device performed by trained nursing staffs.
Single-center prospective, descriptive study.
All neonates admitted to the Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, who met the high-risk criteria according to Joint Committee of Infant Hearing 1994, American Academy of Pediatrics, were screened with one-step protocol using an automated OAE/ABR device (AccuScreen, GN Otometrics, Denmark). Infants who failed 2 consecutive OAE tests were reconfirmed by ABR prior to discharge. Descriptive analysis was used for the prevalence of pathologic hearing test results, age at screening, duration of procedure, number of risk factors per infant. Univariate analysis using Chi-square test and multiple logistic regression analysis were used for identification of significant risk factors.
Five hundred and seven infants were identified to be at-risk in an 18-month study period. The prevalence of pathologic hearing screening test was 6.7% with unilateral and bilateral pathologic results in 13 and 21 infants (2.6% and 4.1%). Only craniofacial anomalies and mechanical ventilation > 5 days were shown to be independent significant risk factors (42-fold and 4-fold increased risk). Median age at screening test performed was 19 days (range 1-149 days) and almost all infants (97.3%) were screened within 3-month postnatal age. The mean time for hearing screening procedure was 10.7 +/- 8.0 minutes (range 2-60 minutes), 98.1% of procedure was accomplished within 30 minutes.
Hearing screening using automated OAE/ABR devices in high-risk neonates revealed approximately 7% of pathologic results with almost two-thirds having bilateral affected. The significant independent risk factors in this study population were craniofacial anomalies and mechnical ventilation > 5 days. The protocol of having trained nursing staffs to perform the screening yielded good results, i.e., the coverage of screened infants within 3 months of age (97%), feasible duration of procedure.
确定高危新生儿病理性听力筛查测试结果的患病率及显著危险因素，以及由经过培训的护理人员使用自动耳声发射（OAE）/听性脑干反应（ABR）设备实施听力筛查项目的可行性。
单中心前瞻性描述性研究。
所有入住玛希隆大学诗里拉吉医院医学院儿科学系新生儿科、符合1994年美国儿科学会婴儿听力联合委员会高危标准的新生儿，使用自动OAE/ABR设备（AccuScreen，丹麦GN Otometrics公司）采用一步法方案进行筛查。连续两次OAE测试未通过的婴儿在出院前通过ABR进行再次确认。对病理性听力测试结果的患病率、筛查时的年龄、检查持续时间、每个婴儿的危险因素数量进行描述性分析。使用卡方检验进行单因素分析，并使用多因素逻辑回归分析来确定显著危险因素。
在为期18个月的研究期间，共确定507名婴儿为高危对象。病理性听力筛查测试的患病率为6.7%，其中13名婴儿为单侧病理性结果，21名婴儿为双侧病理性结果（分别为2.6%和4.1%）。仅颅面畸形和机械通气超过5天被证明是独立的显著危险因素（风险分别增加42倍和4倍）。筛查测试时的中位年龄为19天（范围为1 - 149天），几乎所有婴儿（97.3%）在出生后3个月内接受了筛查。听力筛查程序的平均时间为10.7 +/- 8.0分钟（范围为2 - 60分钟），98.1%的检查在30分钟内完成。
在高危新生儿中使用自动OAE/ABR设备进行听力筛查，发现约7%的病理性结果，其中近三分之二为双侧受累。本研究人群中的显著独立危险因素是颅面畸形和机械通气超过5天。由经过培训的护理人员执行筛查方案取得了良好效果，即3个月龄内婴儿的筛查覆盖率（97%），以及可行的检查持续时间。
