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目的 探讨非听力因素对新生儿听性行为反应的影响 ,为提高新生儿行为测听法的灵敏度和特异性提供参考。方法 10 2名正常新生儿按分娩方式分为顺产组 4 2例 ,剖宫产组 6 0例 ,经瞬态诱发性耳声发射 (transientevokedotoacousticemission ,TEOAE)测试 ;后声场给声 ,刺激声分别为 3kHz纯音、高频窄带噪声及白噪声 ,声强为 90dBSPL分析恒定强度下眼睑反应、头颈反应、面部反应、肢体反应的引出率。结果 10 2名新生儿均可引出良好的TEOAE波形。眼睑反应的引出率两组无差异 ,高频窄带噪声的头部反应引出率顺产组高于剖宫产组 (P <0 .0 5) ,3kHz纯音和白噪声的面部反应引出率顺产组明显高于剖宫产组 (P<0 .0 1) ,三种刺激声的肢体听反应引出率顺产组均高于剖宫产组 (P <0 .0 1)。结论 除听力因素外 ,其他可能导致新生儿宫内缺氧的因素有可能对新生儿听性行为反应产生影响 ,眼睑反应是新生儿中听性行为反应最灵敏的观察指标
Objective To investigate the effect of non-audiometric factors on the hearing performance of neonates and to provide references for improving the sensitivity and specificity of neonatal behavioral audiometry. Methods Totally 102 normal neonates were divided into delivery group (42 cases) and cesarean section group (60 cases) by transientevokedotoacousticemission (TEOAE). The sound and stimuli of the posterior acoustic field were 3kHz pure tone, high frequency narrowband noise and white noise, sound intensity of 90dBSPL Analysis of eyelid response under constant intensity, head and neck reaction, facial response, limb response rate. Results All 10 newborns could lead to good TEOAE waveform. Eyelid response rate was no difference between the two groups, high-frequency narrow-band noise response rate of the head of the cesarean delivery group than the cesarean section (P <0. 05), 3kHz pure tone and white noise response rate of facial response was significantly Higher than the cesarean section group (P <0. 01), three kinds of stimuli acoustic limb lead rate of hearing in the cesarean section group were higher (P <0.01). Conclusion In addition to hearing factors, other factors that may lead to neonatal intrauterine hypoxia may have an impact on neonatal hearing response, eyelid response is the most sensitive indicators of neonatal behavioral response to hearing