目的 探讨未通过听力筛查的婴幼儿听力变化情况及其特点,为听力损失的早期诊断、早期干预提供科学依据。方法 对109例因新生儿听力筛查初筛及复筛均未通过而转诊至本院的婴幼儿进行听性脑干反应(auditory brainstem response,ABR)及声导抗检测。结果 109例婴幼儿中听力正常者17名(15.6%),听力损失患者92名(84.4%)。92例患者中轻度52例(47.7%),中度17例(15.6%),重度8例(7.4%),极重度15例(13.7%);92例患者中传导性耳聋23例(21.1%),感音神经性耳聋69例(63.3%)。结论 听觉神经系统未发育完善和中耳疾病是导致听力筛查未能通过的重要原因,利用ABR及声导抗进行听力评估并确诊其听力状况,可有效提高检出率,听力异常患儿的复查率低和维吾尔族失访率高是目前亟需解决的问题。

Objective To investigate the hearing change and the characteristic of hearing thresholds of the infants failed in the hearing screening. Methods Totally 109 infants failed in the hearing screening were referred to People's Hospital of Xinjiang Uygur Autonomous Region.The Objective hearing of the infants were evaluated by the auditory brainstem response(ABR) and tympanometry. Results Finally 17( 15.6%) infants were normal hearing subjects and 92( 84.4%) showed hearing loss,including 52(47.7%)with milder hearing loss,17(15.6%)with moderate hearing loss,8 infants (7.4%) with severe hearing loss and 15 infants (13.7%) with very severe hearing loss.23 cases( 21.1%) of conductive hearing loss and 69 cases( 63.3%) of sensorineural hearing loss. Conclusions Development of auditory system and middle ear function in infants are the important factors in hearing screening.ABR and tympanometry for hearing evaluation and diagnose could improve the detection rate and provide useful information for early identification and intervention in this population.However,poor follow-up compliance and high loss of follow-up rate of Uygur are still big problems demanding urgent resolution.