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【目的】探讨快速脑干听觉诱发电位(auto-auditory brainstemresponse,AABR)在基层儿童保健听力筛查工作中的应用价值和模式。【方法】对本院出生的新生儿中300例重点筛查对象在出生后2～5 d至出院前采用耳声发射(transient evoked otoacoustic emission,OAE)+AABR进行初筛,未通过者于出生后42 d内进行复筛,仍未通过者转广州市儿童医院听力保健中心或其他具有新生儿疾病(听力)检测资格的三级医院进行脑干听觉诱发电位(auditory brain-stemresponse,ABR)确诊。【结果】初筛OAE未通过率为13.83%,接受AABR复筛未通过率为6.67%,31例复筛未通过者转入听力诊断程序。经过上级医院检查13例被确诊为听力损伤,所有病例AABR筛查结果均未通过,其中有2例双耳OAE筛查通过而单耳AABR筛查未通过。【结论】 AABR具有准确、快速、方便、无创等优点,能降低OAE筛查的假阳性和假阴性率,二者联合应用可减少转诊人数并且降低费用,值得在基层听力筛查中推广应用。
【Objective】 To investigate the value and pattern of auto-auditory brainstem response (AABR) in hearing-screening of primary care in children. 【Methods】 Three hundred newborn infants born in our hospital were preliminarily selected from 2 to 5 days after birth and discharged before being discharged from the hospital with transient evoked otoacoustic emission (OAE) + AABR. 42 days after the re-screening, have not yet passed to the Guangzhou Children’s Hospital Hearing Health Center or other hospitals with neonatal disease (hearing) testing of tertiary hospitals for auditory brain-stem response (ABR) diagnosis . 【Results】 The failure rate of primary OAE was 13.83%, that of non-passing AABR secondary screening was 6.67%, and that of 31 failed secondary screening was transferred to hearing test. After superior hospital examination 13 cases were diagnosed as hearing impairment, all cases of AABR did not pass the screening results, including 2 cases of bilateral ear OAE screening and single ear AABR screening failed. 【Conclusion】 AABR is accurate, rapid, convenient and noninvasive. It can reduce the false positive rate and false negative rate of OAE screening. The combination of the two methods can reduce the number of referrals and reduce the cost, which is worth to be popularized in primary hearing screening .