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目的:探讨听力筛查未通过的婴幼儿的听力变化及其特点。方法:对使用ABR、DPOAE、声导抗而未通过听力筛查的新生儿分别在3月龄及6月龄时行客观听力检查,将2次检查结果进行比较和分析。结果:DPOAE在3月龄时测试假阳性率为9.6%;6月龄的复查和3月龄的初查相比较,重度或极重度听力损失者听力基本无改变,而轻-中度听力损失者转化为正常或听力改善所占的比例较高;将3月龄和6月龄2次ABR检查所得的ABR阈值,分左、右耳侧,前、后比较,左侧t=3.496,P<0.01,右侧t=5.572,P<0.01,差异有统计学意义。结论:未通过DPOAE筛查者不能立即作出听力损伤的结论,必须与ABR检查相互结合,相互补充;重度以上的听力损失者3月龄的早期诊断和6月龄的早期干预是可行的,而轻-中度听力损失者应进行至少2次以上的听力检测和6个月以上的追踪,并根据听觉行为测试和日常生活观察综合分析各项检查结果后才可得出正确诊断。
Objective: To investigate the hearing changes and characteristics of infants and young children who fail to pass the hearing screening. Methods: Objective hearing tests were performed on 3-month-old and 6-month-old neonates using ABR, DPOAE, and acoustic impedance without hearing screening. The results of two tests were compared and analyzed. Results: The false positive rate of DPOAE at 3 months of age was 9.6%. At 6 months of age, the hearing of patients with severe or severe hearing loss was almost unchanged, while mild to moderate hearing loss The percentage of patients with ABR at two months at 3 months and 6 months of age was divided into left and right ear, front and back, left = t = 3.496, P <0.01, right t = 5.572, P <0.01, the difference was statistically significant. Conclusion: The conclusion that hearing loss can not be done immediately without DPOAE screening must be combined with ABR examination and complement each other. Early diagnosis of severe hearing loss at 3 months and early intervention at 6 months of age are feasible. However, Light - moderate hearing loss should be at least 2 times more than the hearing test and more than 6 months of follow-up, and based on auditory behavioral tests and daily life observed after a comprehensive analysis of the test results before the correct diagnosis can be drawn.