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題 名 | 以聽性腦幹反應篩檢出生體重低於1500公克早產兒之聽力=A Hearing Screening in Very Low Birth Weight Preterm Infants by Auditory Brainstem Response |
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作 者 | 吳俊良; 黃朝慶; 高純珠; | 書刊名 | 中華民國耳鼻喉科醫學會雜誌 |
卷 期 | 33:3 1998.06[民87.06] |
頁 次 | 頁32-38 |
分類號 | 417.6813 |
關鍵詞 | 聽力篩檢; 出生體重非常小之新生兒; 聽性腦幹反應; Hearing screening; Very low birth weight newborns; Auditory brainstem response; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:聽性腦幹反應檢查( ABR )是一常用的新生兒聽力篩檢工具,尤其對於聽 障高危險群新生兒的聽力障礙偵測格外重要。本研究是針對聽障高危險群其中之一的出生體 重低於 1500 公克的出生體重非常小( very low birth weight, VLBW )之新生兒, 以 ABR 檢查作聽力評估,分析他們的聽障發生率; 並試圖找尋出合適的 ABR 對聽力異常的篩 檢標準。 方法:收集來自臺南巷地區的醫學中心、區域及地區醫院之出生體重低於 1500 公克新生兒 ,共計 88 名,其中男嬰 41 名、女嬰 47 名。於矯正後年齡為 6 個月時,接受 ABR 檢查 。 我們用兩種不同標準去定義 ABR 判斷聽力篩檢不合格,一為較寬鬆的標準 A:第五波閾 值≧ 35dB nHL;另一個是較嚴格的標準 B:第五波閾值≧ 25dB nHL 者。 所有被判定為不 合格之嬰兒均接受追蹤檢查,以行為聽力檢查確定是否有聽力障礙。 結果:所有 88 名嬰兒中,有 8 名確定是聽力障礙者,發生率為 9%。 以標準 A 認定的不 合格率為 16%,聽障預測率為 57%, 而標準 B 的不合格率為 22%,它比前者增加了 6% 的 不合格率,但後來證實這些多出的不合格者均為偽陽性,聽障預測率則為 42%。 結論:從本研究結果顯示出生體重低於 1500 公克新生兒的聽障發生率為 9%。 ABR 是一項 很有效率之新生兒聽力篩檢工具,其聽障預測率很高,凡是聽障高危險群的新生兒,建議均 應接受 ABR 聽力篩檢。 我們覺得以第五波閾值≧ 35dB nHL 為不合格的判定標準是比較合 適的,更嚴格的判定標準只有提高偽陽性率,增加後續追蹤所需的醫療成本,而再寬鬆的標 準則會疏失掉有聽障的嬰兒。 |
英文摘要 | Background: ABR has been used as an objective, non-invasive tool to screen neonatal deafness. In this article, we evaluated the prevalence of deafness in VLBW preterm newborns by ABR, and attempted to search for a suitable failed/passed criterion. Methods: ABR screening test was performed in 88 VLBW preterm newborns. The infants whose threshold was ≧ 35dB nHL were classified as "Group A"; those whose threshold was ≧ 25dB nHL were classified as "Group B". All of the newborns of either Group A or Group B received the successive ABR screening test and behavioral audiometry to confirm whether they have hearing impairment or not. Results: Fourteen newborns (16%) were included in Group A and 19 newborns (22%) in Group B. These were five newborns who belonged to Group B, but not to Group A; all of them were found to have normal hearing in the successive test. Eight newborns (9%) were defined to have hearing impairment finally, they all belonged to both Group A and Group B. Incidence of deafness in Group A is 57%; however, 42% in Group B. The predictive value of deafness in Group A was better than that in Group B. Conclusions: The prevalence of deafness in VLBW newborns was 9%. ABR is a tool with high sensitivity and predictive rate in neonatal hearing screening. Threshold ≧ 35dB nHL is preferable criterion for ABR screening. We recommend that all of the newborns who were considered to have risk factors of deafness should be referred for ABR testing in order to lower the average age of diagnosis. |
本系統中英文摘要資訊取自各篇刊載內容。