摘要
目的分析135298例新生儿听力筛查结果及部分小儿的转诊情况,探讨进一步完善听力筛查工作的促进措施。方法回顾性分析北京市妇产医院2010至2019年10年期间新生儿听力筛查结果。初筛采用畸变产物耳声发射(DPOAE),复筛采用畸变产物耳声发射联合自动听性脑干反应(AABR),复筛未通过者转诊至听力诊断中心进行诊断性检查,期间在2010年至2011年完善首都医学发展科研基金课题,对三阶段筛查模式进行探讨,即复筛未通过小儿在转诊至诊断中心做诊断性检查前进行第三次听力筛查,之后再进行诊断性检查,比较两阶段筛查模式及三阶段筛查模式的阳性预测值;部分复筛未通过小儿进行电话追访,记录转诊及就诊情况及检查结果。结果1.共筛查新生儿135298例,初筛未通过者7402例,实际复筛6467例;十年间初筛阳性率及转诊率呈下降趋势,复筛率及复筛阳性率呈上升趋势,差异有统计学意义。2.复筛工作中DPOAE与AABR联合筛查的比例逐渐升高。3.三阶段筛查模式阳性预测值51.3%,高于两阶段筛查模式,差异有统计学意义。4.电话追访2017年至2018年复筛未通过小儿共287例,132例(46%)于指定听力诊断中心就诊,57例(19.9%)自主选择其它听力诊断中心、综合医院耳鼻喉科或社区,13例(4.5%)外地就诊,72例(25.1%)未就诊,13例(4.5%)失访,听力异常者21例,听力损失发病率0.07%。结论北京市新生儿听力筛查工作已逐步形成体系,转诊至诊断中心患儿的就诊率有待提高,加强健康教育、提高筛查人员技术水平、加强追访力度等对提高筛查及诊断的依从性具有重要意义。
Objective:Through analyzing the outcome of 135298 newborns′hearing screening and the referral of partial children,to discuss the promotion measures then furtherly to improve the work of hearing screening.Methods:The results of newborn hearing screening in Beijing Obstetrics and Gynecology Hospital from 2010 to 2019 were retrospectively analyzed.DPOAE was used for primary and secondary screening,and AABR was used for secondary screening.Those who failed the secondary screening were referred to the Hearing Diagnosis and Treatment Center for diagnostic examination.During the period from 2010 to 2011,the subject of the Capital Medical Development Scientific Research Fund was improved,and the three-stage screening mode was explored,that is,the third hearing screening was carried out before the children were referred to the diagnostic center,then the diagnostic examination was carried out to compare the positive predictive value of the two-stage screening mode and the three-stage screening mode.Results:1.A total of 135,298 newborns were screened,7402 failed in primary screening and 6467 re-screened in practice.The positive rate of primary screening and referral rate showed a downward trend in the past ten years,while the positive rate of re-screening and re-screening rate showed an upward trend,with a statistically significant difference.2.The proportion of DPOAE combined with AABR screening in the re-screening gradually increased.3.The positive predictive value of three-stage screening mode was 51.3%,which was higher than that of two-stage screening mode,and the difference was statistically significant.4.Telephone follow-up 287 children did not pass the re-screening from 2017 to 2018,132(46%)visited the designated hearing diagnostic center,57(19.9%)chosed other hearing diagnostic centers,general hospital or community,13(4.5%)visited outside,72(25.1%)did not visit,13(4.5%)were lost to follow-up.21 cases were diagnosed as hearing impaired and the positive rate of hearing loss was 0.07%.Conclusion:The rate of children referred to the diagnosis center needs to be improved.It is of great significance to strengthen health education,improve the technical level of screeners,and enhance the follow-up in order to raise compliance of the parents.
作者
贾晓
张巍
马建荣
张淑燕
JIA Xiao;ZHANG Wei;MA Jian-rong;ZHANG Shu-yan(Beijing Obstetrics Gynecology Hospital Affiliated to Capital University of Medical Science,Beijing,100026,China)
出处
《中国优生与遗传杂志》
2020年第7期853-856,共4页
Chinese Journal of Birth Health & Heredity
关键词
新生儿
听力筛查
结局
依从性
Newborn
Hearing screening
Outcome
Compliance
