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听力障碍属于临床一种较常见的出生缺陷,于各类先天遗传病中所占比例较高,临床需尽早进行筛查。伴随诊疗技术的发展,瞬态诱发耳声发射(TEOAE)和自动听性脑干反应(AABR)广泛应用于新生儿听力障碍疾病筛查中[1-3]。本文分析有听力损害因素的高危新生儿140例双耳TEOAE初次检查通过与未通过,及TEOAE、AABR单独和联合检查方法初筛与复筛通过率。现作报道。
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观察组于不同筛查方法初筛和42 d复筛、3个月复筛中通过率均明显高于对照组(P < 0.01)(见表 1)。
分组 n 初筛 42 d复筛 3个月复筛 AABR TEOAE 联合法 AABR TEOAE 联合法 AABR TEOAE 联合法 对照组 120 79(65.83) 0(0.00) 0(0.00) 87(72.50) 96(80.00) 82(68.33) 96(80.00) 98(81.67) 91(75.83) 观察组 160 139(86.88) 160(100.00) 139(86.88) 145(90.63) 158(98.75) 140(87.50) 158(98.75) 159(99.38) 150(93.75) χ2 — 17.61 280.00 207.02 15.86 28.62 15.34 28.62 28.52 18.36 P — < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 表 1 2组初筛与复筛通过情况比较[n;百分率(%)]
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TEOAE、AABR单独检查于初筛和42 d复筛中通过率均明显高于联合检查法(P < 0.01), 但在3个月复筛中通过率差异无统计学意义(P>0.05)。
分组 n 初筛 42 d复筛 3个月复筛 AABR 280 218(77.86) 232(82.86) 254(90.71) TEOAE 280 160(57.14) 254(90.71) 257(91.79) 联合检查法 280 139(49.64) 222(79.29) 241(86.07) χ2 — 34.65 14.45 5.51 P — < 0.01 < 0.01 >0.05 表 2 不同筛查方法初筛与复筛通过情况比较[n;百分率(%)]
TEOAE联合AABR在高危新生儿听力筛查中的价值研究
Value of TEOAE combined with AABR in hearing screening in high-risk newborn
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摘要:
目的探讨瞬态诱发耳声发射(TEOAE)和自动听性脑干反应(AABR)联合应用在高危新生儿听力筛查中的价值。 方法选择有听力损害因素的高危新生儿140例作为研究对象,按照双耳TEOAE初筛是否通过分为2组,未通过的60例患儿设为对照组,通过的80例患儿设为观察组,分别在出生后42 d与3个月进行复筛,比较2组TEOAE、AABR单独和联合检查方法初筛与复筛通过率。 结果观察组于TEOAE、AABR单独和联合检查法初筛和42 d复筛、3个月复筛中通过率均明显高于对照组(P < 0.01)。TEOAE、AABR单独检查于初筛和42 d复筛中通过率均明显高于联合检查法(P < 0.01),但在3个月复筛中通过率差异无统计学意义(P>0.05)。 结论对于高危新生儿的听力筛查,TEOAE和AABR联合应用的价值较高,可使漏诊率与假阳性率降低,值得临床应用。 Abstract:ObjectiveTo explore the value of transient evoked otoacoustic emissions (TEOAE) combined with automatic auditory brainstem response (AABR) in hearing screening in high-risk newborns. MethodsA total of 140 high-risk newborns with hearing impairment factors were selected and divided into two groups according to whether their two ears passed the TEOAE primary screening.Sixty newborns who failed to pass the primary screening were set as the control group, and 80 newborns who passed the primary screening were set as the observation group.The re-screening was performed at 42 days and 3 months after birth, respectively.The passing rate of newborns in primary screening and re-screening by TEOAE, AABR, and TEOAE combined with AABR were compared between the two groups. ResultsThe passing rate in the primary screening and re-screening at 42 days and 3 months after birth by TEOAE, AABR, and TEOAE combined with AABR in observation group was significantly higher than that in control group (P < 0.01).The passing rate in the primary screening and re-screening at 42 days after birth by TEOAE and AABR was significantly higher than that by TEOAE combined with AABR (P < 0.01), but there was no significant difference in the passing rate of re-screening at 3 months after birth (P>0.05). ConclusionsThe combination of TEOAE and AABR has high values in hearing screening in high-risk newborns, which can reduce the incidences of missed diagnosis and false-positive rates, and is worthy of clinical application. -
表 1 2组初筛与复筛通过情况比较[n;百分率(%)]
分组 n 初筛 42 d复筛 3个月复筛 AABR TEOAE 联合法 AABR TEOAE 联合法 AABR TEOAE 联合法 对照组 120 79(65.83) 0(0.00) 0(0.00) 87(72.50) 96(80.00) 82(68.33) 96(80.00) 98(81.67) 91(75.83) 观察组 160 139(86.88) 160(100.00) 139(86.88) 145(90.63) 158(98.75) 140(87.50) 158(98.75) 159(99.38) 150(93.75) χ2 — 17.61 280.00 207.02 15.86 28.62 15.34 28.62 28.52 18.36 P — < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 表 2 不同筛查方法初筛与复筛通过情况比较[n;百分率(%)]
分组 n 初筛 42 d复筛 3个月复筛 AABR 280 218(77.86) 232(82.86) 254(90.71) TEOAE 280 160(57.14) 254(90.71) 257(91.79) 联合检查法 280 139(49.64) 222(79.29) 241(86.07) χ2 — 34.65 14.45 5.51 P — < 0.01 < 0.01 >0.05 -
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