中国儿童保健杂志 ›› 2015, Vol. 23 ›› Issue (11): 1224-1225.DOI: 10.11852/zgetbjzz2015-23-11-33

• 经验交流 • 上一篇    下一篇

耳声发射和自动听性脑电反应联合进行新生儿听力筛查结果分析

陈磊,严菊花   

  1. 昆山市妇幼保健所,江苏 昆山 215300
  • 收稿日期:2015-04-13 发布日期:2015-11-10 出版日期:2015-11-10
  • 作者简介:陈磊(1984-),男,山东人,主管医师,硕士学位,主要从事儿童保健工作。
  • 基金资助:
    昆山市科技计划项目(001206)

Result analysis of combined using otoacoustic emission and auto auditory brainstem respons tests in universal newborn hearing screening

CHEN Lei,YAN Ju-hua   

  1. Kunshan Maternal and Child Health Care Hospital,Kunshan,Jiangsu 215300,China
  • Received:2015-04-13 Online:2015-11-10 Published:2015-11-10

摘要: 目的 了解耳声发射(otoacoustic emission,OAE)、自动听性脑电反应(auto auditory brainstem respons,AABR)以及联合筛查的灵敏度、特异度、漏诊率、误诊率。方法 在新生儿出生后3~5 d采用OAE进行听力筛查,筛查未通过者于出生后42 d时进行OAE和AABR联合筛查,联合筛查仍未通过者,转诊至上级医院进行常规脑干诱发电位(auditory brainstem respons,ABR)和声阻抗检查,并对听力障碍进行诊断和分类。OAE和AABR作为并联试验,当两种筛查方法中有一种未通过即判为筛检试验阳性,两种方法均通过判为筛检试验阴性。结果 共完成新生儿OAE和AABR联合筛查1 271例,通过者1 064例,未通过者207例。出生后42 dOAE复筛比OAE初筛灵敏度略有提高;单独使用AABR筛查,灵敏度较低,特异度较高;OAE和AABR联合筛查的灵敏度高于单一方法筛查的灵敏度,漏诊率降低。结论 采用OAE进行新生儿听力筛查存在较高的漏诊率,OAE和AABR联合筛查能够有效的减少漏诊率,因此联合筛查的方法值得推广。

关键词: 听力筛查, 耳声发射, 自动听性脑电反应, 灵敏度, 特异度

Abstract: Objective To learn the sensitivity,specificity,the rate of missed diagnosis,misdiagnosis rates of otoacoustic emission (OAE),auto auditory brainstem respons (AABR) and the combined screening. Method OAE hearing screening were carried out in the 3~5 d after birth,each referred infant received OAE joint AABR screening in 42 days after birth.Those who have not passed the combined screening referral to higher hospital for ABR,acoustic impedance examination and the diagnosis and classification of hearing impairment.AABR and OAE as a parallel method of testing,anyone of the two method referred was positive,both of them passed was negative. Results 1 271 newborns received OAE and AABR combined screening,1 064 passed,207 did not pass.The sensitivity of OAE screening in the 42 days after birth was slightly higher;Compared with OAE,AABR screening had a lower sensitivity and higher specificity;Combined screening had improved the sensitivity and reduced the rate of missed diagnosis than a single method of screening. Conclusion Using OAE newborn hearing screening have a higher rate of missed diagnosis,OAE and AABR combined screening can effectively reduce the rate of missed diagnosis,and therefore worthy to be popularized.

Key words: hearing screening, otoacoustic emission, auto auditory brainstem respons, sensitivity, specificity

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