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1、.新生儿听力障碍影响因素的调查与研究乐凌1作者单位:315010浙江省宁波市第一医院耳鼻喉科乐凌:女,本科,副主任护师,护士长本课题为宁波市卫生局立项课题(项目编号:2004027)唐世雄1夏佳芬2余爱萍1李宛珍1(1.宁波市第一医院,2.宁波市妇女儿童医院,浙江宁波315010)【摘要】目的通过新生儿听力筛查,了解本地区新生儿听力障碍的发病率,并对其听力障碍的影响因素进行调查与研究。方法利用瞬态诱发耳声发射(TEOAE)对出生三天的新生儿进行检测(初筛),未通过者于出生后42天进行第二次TEOA
2、E检测(复筛1),仍未通过者于出生后3个月再次复筛(复筛2),可疑者同时进行脑干听觉诱发电位(ABR)的检测诊断,并对听力障碍者进行多因素的调查与研究。结果本组共筛查6837例新生儿中有5874例通过初筛,初筛通过率为85.92%,经ABR确诊为不同程度听力障碍者18例,发生率为0.263%,且初筛未通过例数为男性大于女性(X2=4.572,P=0.033),左耳大于右耳(X2=15.589,P=0.000)。经Logistic回归分析,最终影响听力障碍因素中仅有母亲怀孕时有流感史、胎儿脐带绕颈、
3、出生时缺氧或窒息、出生后感冒进入回归模型。结论TEOAE可以作为开展大规模的新生儿听力筛查的一项常规技术方法,值得推广、应用。耳蜗对外界声刺激的反应存在着性别及左右耳的差别。影响新生儿听力障碍的相关因素可能为母亲怀孕时流感史、胎儿脐带绕颈、出生时缺氧或窒息以及出生后感冒。【关键词】新生儿;听力障碍;影响因素;TEOAE;ABR;InvestigationoftheinfluencefactorsofnewbornshearingimpairmentLELing,TANGShi-Xiong,XIAJ
4、ia-Feng,etal.NingboNo.1Hospital,ZheJiang315010,China[Abstract]ObjectiveTocomprehendtheincidenceofnewbornshearingimpairment,andinvestigatetheinfluencefactorsofhearingimpairmentbythenewbornshearingscreening.MethodsInspectingthenewbornsafter3daysbyTEOAE.
5、Theno–passedwereinspectedbyTEOAEafter42days,Thestillno–passedwereinspectedagainafterborned3months,TheshadinesswereinspectedbyABRatthesametime,andthehearingimpairmentwereinspectedtofindthefactor.ResultThereare5874newboresthatpasstheinvestigationfrom683
6、7newbores.Thepassingrateis85.92%.Thereare18caseswerediagnoseddefferentdegreehearningimpairmentbyABR,Theoccurrateis0.263%.Thenopassedcasesinvesigated...inthefirsttimeismale,morethanfemale(X2=4.572,P=0.033).Leftearmorethanright(X2=15.589,P=0.000).Across
7、Logisticregressanalysis,atlast,theinfluencefactorsofhearingimpairmentareonlythemotherpregnancyfluhistory,umbilicalcordcircleingneck,borninganoxicorasphyxia,catchingcoldafterborningintotheregressmodel.ConclusionTEOAEisgoodforapplicationasaregulartechno
8、logytoinspectthenewbornshearinginlargescope,theinfectionofthecochleatotheenvironmenthasdifferenteinsexandrightorleftear.Theinfluencefactorsthenewbornshearingimpairmentmaybethemotherpregnancyfluhistory,umbilicalcordcircleingneck,borninganoxicor