摘要
人類幼兒期的聽覺經驗，將有意義地影響語言、認知、學習等發展，為使聽障兒能在學習關鍵期(0至3歲)即被發現，以及早展開治療和復健，因此新生兒聽力篩檢十分重要。台北榮民總醫院聽力檢查師、耳科醫師和小兒科醫師，於民國79年9月至80年8月，對院內出生的新生兒進行聽力篩檢。篩檢分聽障高危險群和非聽障高危險群新生兒兩組進行，聽力篩檢則以行為觀察聽力檢查、聽性 腦幹反應檢查及鼓室圖3種方法，並配合耳鏡檢查及問卷調查。1年來共有1885名新生兒接受篩檢，聽陣養生率在0.32%至0.48%，其中傳音性聽障發生率為0.21%至0.37%，感音性聽障發生率為0.11%。聽障高危險群占全體生兒的2.7% (50/1885)，其聽障發生率為8%至14%。非聽障高危群之聽障發生率則為0.11%。 郵寄問卷回覆率約50%且未篩檢出聽障兒，行為觀察聽檢之假陰性為89%，此兩種方法在本研究中均非有效的篩檢方法。若以聽性腦幹反應檢查對高危險群新生兒進行篩檢，則只須篩檢2.7%的人口，便能篩檢出約67%至78%的聽障兒，應屬經濟有效的篩檢方法，但檢查年齡則以新生兒受孕後週數(PCA)大於48週為較佳時期。
關鍵字
無資料並列摘要
Auditory deprivation in early life significantly effects speech, language, cognition and learning development. The importance of neonatal hearing screening in order to detect and manage children with hearing impairment during the critical period before three years of age can’t be neglected. The neonatal hearing screening program at Veterans General Hospital, Taipei, under a cooperation of audiologists, otologists and pediatricians, identified 1885 neonates for hearing loss from September 1990 to August 1991. There were two study groups, a high risk group of hearing impairment and a non- high risk group. We performed hearing screening and followed-up for the failure at initial test using methods including behavioral observation audiometry, auditory brainstem response, tympanogram, pneumatic otoscopy and questionnaire. Approximately 2.7% of neonates were classified as high risk for hearing loss, the incidence of hearing loss was 8% to 14% in this group. The incidence of hearing loss in non-high risk group was 0.11%. If both groups were contained that the incidence of hearing loss was 0.32% to 0.48%, 0.11% with a sensorineural hearing loss, 0.21% to 0.37% with a conductive hearing loss. Both behavioral audiometry (89% false negative rate) and questionnaire (50% return rate) were not effective for screening purposes in this study. Our results also indicated that the most advantage of using a high risk register lay in the fact that only 2.7% of a total population needed to be screened to identify approximately 67% to 78% of hearing-impaired babies. This saved both time and money.
延伸閱讀
- 林政佑、黃啟原、吳俊良、林愛惜（2002）。都會區的新生兒聽力篩檢。中華民國耳鼻喉科醫學雜誌，37(5)，321-329。https://doi.org/10.6286/2002.37.5.321
- 陳曉屏、劉殿楨（2004）。嬰幼兒的聽力檢查。健康世界，(224)，41-44。https://doi.org/10.6454/HW.200408.0041
- 張葉蘭、韋秀桃、區淑燕、林潔蕾（2021）。新生兒聽力篩查結果分析。鏡湖醫學，21(1)，78-80。https://www.airitilibrary.com/Article/Detail?DocID=P20230317001-N202303220009-00027
- 趙文元（1995）。小兒的聽力篩檢。當代醫學，(260)，481-483。https://doi.org/10.29941/MT.199506.0010
- Zhang, W. (2008). Alternative methods in neonatal hearing screening [doctoral dissertation, The University of Hong Kong]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0029-1812201200014912