厦门市12443例学龄前儿童听力筛查结果分析

Analysis of Hearing Screening Results from 12 443 Preschool Children in Xiamen City

谢石荣;吴晓军;张国旺;阳海林;陈嘉菲;张丽萍;

1:厦门大学附属妇女儿童医院厦门市妇幼保健院耳鼻咽喉科厦门市听力筛查诊断中心

2:福建医科大学

3:厦门市海沧区卫生计生监督所

摘要
目的分析厦门市部分学龄前儿童听力筛查结果,了解近年来该地区学龄前儿童的听力情况,并评估筛查模式的有效性。方法 2016~2018年应用筛查型畸变产物耳声发射(DPOAE)和声导抗对厦门市36所幼儿园中班学龄前儿童12 443例进行听力筛查,筛查未通过者转诊进行诊断型耳声发射、声导抗、行为测听或听性脑干反应(ABR)测试,必要时行颞骨CT、核磁共振(MRI)检查,进行听力学诊断。结果 12 443例学龄前儿童中11 726例(94.2%,11 726/12 443)接受听力筛查,未通过1 307例(11.1%,1 307/11 726);1 069例(81.8%,1 069/1 307)接受转诊,确诊听力异常414例,听力损失检出率为3.53%(414/11 726),诊断为分泌性中耳炎373例(34.9%,373/1 069),感音神经性听力损失41例(3.8%,41/1 069)。比较2016~2018年听力筛查率、未通过转诊率、家长对耳及听力保健相关知识掌握率逐年升高,差异有统计学意义(P<0.001)。结论本组学龄前儿童听力损失检出率为3.53%,其中分泌性中耳炎检出率最高;筛查型DPOAE和声导抗联合筛查模式用于学龄前儿童听力筛查可行且有效,有利于提高转诊率。
关键词
学龄前儿童;听力筛查;耳声发射
基金项目(Foundation):
作者
谢石荣;吴晓军;张国旺;阳海林;陈嘉菲;张丽萍;
参考文献

1 Wake M,Tobin S,Cone-Wesson B,et al.Slght/mild sensorineual hearing loss in children[J].Pediatrics,2006,118:1842.

2 Bamford J,Fortnum H,Bristow K,et al.Current practice,accuracy,effectiveness and cost-effectiveness of the school entry hearing screen[J].Health Technol Assess,2007,11:1.

3 Bamford J,Uus K,Davis A.Screening for hearing loss in childhood:issues,evidence and current approaches in the UK[J].J Med Screen,2005,12:119.

4 Fortnum HM,Summerfield AQ,Marshall DH,et al.Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening:questionnaire based ascertainment study[J].BMJ,2001,323:536.

5 The American Academy of Audiology of Childhood Hearing Screening Guidelines.2011.http://audiology-web.s3.amazonaws.com/migrated/ChildhoodScreeningGuidelines.pdf_5399751c9ec216.42663963.pdf

6 陶泽璋,杨琨.儿童听力筛查的必要性[J].听力学及言语疾病杂志,2017,25:113.

7 程晓华,黄丽辉,亓贝尔,等.616例学龄前儿童听力筛查结果分析[J].听力学及言语疾病杂志,2018,26:1.

8 吕静荣,黄治物,马衍,等.学龄前儿童迟发性听力损失筛查研究[J].听力学及言语疾病杂志,2013,21:221.

9 谢石荣,吴晓军.民营医院健康教育在流动儿童听力保健中的应用[J].中国妇幼保健,2017,32:3409.

10 Morton CC,Nance WE.Newborn hearing screening-a silent revolution[J].N Engl J Med,2006,354:2151.

11 Khairi Md Daud M,Noor RM,Rahman NA,et al.The effect of mild hearing loss on academic performance in primary school children[J].Int J Pediatric Otorhinolaryngology,2010,74:67.

12 Brooks DN.Hearing screening:a comparative study of an impedance method and pure tone screening[J].Scandinavian Audiology,1973,2:67.

13 McCurdy JA Jr,Goldstein JL,Gorski D.Auditory screening of preschool children with impedance audiometry—a comparison with pure tone audiometry:detecting otologic disease prior to the onset of hearing loss[J].Clin Pediatr (Phila),1976,15:463.

14 Flanary Valerie A,Flanary Casey J,Colombo Jo A,et al.Mass hearing screening in kindergarten students[J].Int J Pediatric Otorhinolaryngology,1999,50:93.

15 Robers J,Hunter L,Gravel J,et al.Otitis media,hearing loss,and language learning:controversies and current research[J].J Dev Behav Pediatr,2004,25:110.

16 Vernon-Feagans L,Manlove E.Otitis media,the quality of child care,and the social/communicative behavior of toddlers:a replication and extension[J].Early Child Res Quart,2005,20:306.

17 徐静,郑芸,梁传余,等.183例学龄前儿童听力筛查结果分析[J].听力学及言语疾病杂志,2004,12:258.

18 赖丹,蒲俊梅,刘璐,等.0~6岁儿童听力筛查及诊治信息管理系统的研发和临床应用[J].听力学及言语疾病杂志,2017,25:308.