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目的探讨基层地区医院内两步听力筛查模式的有效性。方法选择2008年11月至2010年4月出生于安阳市妇幼保健院、并接受瞬态诱发性耳声发射筛查的新生儿,医院内第一次初筛单耳或双耳未通过的新生儿于出院前进行第二次初筛或生后42天进行复筛。记录听力筛查时间及双耳筛查结果,按完成听力筛查的时间将新生儿分组,分析通过率与筛查时间的关系、医院内一次初筛和两次初筛后总的通过率,以及医院内第二次初筛与42天复筛两组人群的通过率。结果 (1)完成听力第一次初筛的新生儿共10060例,总体通过率49.1%(4944/10060),通过率随出生后筛查时间的延迟而提高。(2)未通过第一次初筛的新生儿中30.0%(1535/5116)出院前接受第二次初筛,通过率78.4%(1204/1535),两次初筛后总体通过率61.1%(6148/10060),与一次初筛通过率(49.1%)差异有统计学意义(χ2=291.3,P<0.001)。(3)未通过医院内听力初筛的婴儿中39.1%(1531/3912)于42天接受复筛,通过率92.7%(1420/1531),与医院内第二次初筛通过率(78.4%)差异有统计学意义(χ2=127.3,P<0.001)。结论新生儿听力筛查时间是影响通过率的关键因素,随着出生后筛查时间的延迟,初筛通过率逐步提高;医院内两步筛查可提高初筛通过率,但医院内第二次初筛通过率低于42天复筛通过率。
Objective To investigate the effectiveness of two-step audiometric screening in hospitals in primary areas. Methods Neonates born in Anyang MCH Hospital from November 2008 to April 2010 were enrolled in this study. The neonates who had undergone transient screening for otoacoustic emissions were enrolled in the hospital for the first time. Children in the second pre-discharge screening or 42 days after birth for re-screening. Record hearing screening time and binaural screening results, according to the time to complete hearing screening of newborns, the analysis of the relationship between the pass rate and screening time, the hospital once the initial screening and the total pass rate after two primary screening, As well as the second screening of the hospital and 42 days of re-screening two groups of people through rate. Results (1) The total number of newborns who completed the first screening of hearing was 10060. The overall passing rate was 49.1% (4944/10060). The passing rate increased with the delay of screening after birth. (2) 30.0% (1535/5116) of the newborns who did not pass the first primary screening received the second pre-discharge screening rate of 78.4% (1204/1535), the overall pass rate after two primary screening was 61.1% (6148/10060), which was significantly different from the primary screening rate (49.1%) (χ2 = 291.3, P <0.001). (3) 39.1% (1531/3912) of the infants who did not pass the first screening in the hospital received re-screening on the 42nd day, the pass rate was 92.7% (1420/1531), the second pass screening rate in the hospital (78.4% ) Difference was statistically significant (χ2 = 127.3, P <0.001). Conclusion The neonatal hearing screening time is the key factor affecting the passing rate. With the delay of screening time after birth, the screening rate gradually increased; two-step screening in hospital can improve the screening rate, but the hospital second Secondary screening rate of less than 42 days through the screening rate.