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第二期新生儿普遍听力筛查——诊断和开始对听力损失婴儿进行适当治疗的一种方式。

Second stage of Universal Neonatal Hearing Screening - a way for diagnosis and beginning of proper treatment for infants with hearing loss.

机构信息

Department of Otolaryngology, Hearing Implant Center, Medical University of Warsaw, Warsaw, Poland.

Department of Otolaryngology, Hearing Implant Center, Medical University of Warsaw, Warsaw, Poland.

出版信息

Adv Med Sci. 2014 Mar;59(1):90-4. doi: 10.1016/j.advms.2014.02.002. Epub 2014 Mar 25.

Abstract

PURPOSE

To analyze retrospectively the results of hearing testing in infants at the second stage of the Polish Universal Neonatal Hearing Screening Program carried out in the Department of Otolaryngology at the Medical University of Warsaw.

MATERIAL/METHODS: A total of 351 infants referred to our Department for the second stage of UNHS were included in the study. There were 39.60% infants referred due to positive result of hearing screening at the first stage of the Program performed in neonatal units, 55.27% with negative screening but risk factors present, and 5.13% without any tests due to equipment failure in the maternity unit.

RESULTS

Risk factors were identified in 86.61% of the infants. The most frequent ones were hyperbilirubinemia (71.51%), premature birth (63.25%), and ototoxic medication (62.11%). Otoacoustic emission test showed fail results in 17.66% of the infants, and auditory brainstem responses confirmed hearing loss in 16.81%. Correlation between risk factors and confirmed hearing loss was found for hyperbilirubinemia, low birth weight, intensive therapy for at least 7 days, low Apgar scores, and craniofacial abnormalities.

CONCLUSIONS

The early identification of infants with hearing loss is essential for early intervention. Not only infants who fail the initial screening but also the ones with risk factors of hearing impairment should be referred to the centers that are capable of providing the necessary diagnostic services required for the second stage of the UNHSP. Those two steps are needed to both minimize the risk of overlooking a child with hearing loss and properly diagnose hearing impairment.

摘要

目的

回顾性分析在华沙医科大学耳鼻喉科进行的波兰普遍新生儿听力筛查计划第二阶段中对婴儿进行听力测试的结果。

材料/方法:共有 351 名被转介到我科进行 UNHS 第二阶段的婴儿被纳入研究。其中,39.60%的婴儿是由于在新生儿病房进行的计划第一阶段的听力筛查阳性而被转介,55.27%的婴儿是由于筛查阴性但存在危险因素,5.13%的婴儿是由于由于妇产单位的设备故障而没有进行任何测试。

结果

在 86.61%的婴儿中发现了危险因素。最常见的是高胆红素血症(71.51%)、早产(63.25%)和耳毒性药物(62.11%)。在 17.66%的婴儿中,耳声发射测试结果失败,在 16.81%的婴儿中,听觉脑干反应证实存在听力损失。高胆红素血症、低出生体重、至少 7 天的强化治疗、低 Apgar 评分和颅面畸形与确诊听力损失之间存在相关性。

结论

早期识别听力损失的婴儿对于早期干预至关重要。不仅要对初始筛查失败的婴儿,而且要对有听力障碍危险因素的婴儿进行转介,以便他们能够获得 UNHSP 第二阶段所需的必要诊断服务。这两个步骤对于最大限度地减少漏诊听力损失儿童的风险和正确诊断听力障碍都是必要的。

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