都會區的新生兒聽力篩檢

Metropolitan Community Based Newborn Hearing Screening

林政佑(Cheng-Yu Lin) ； 黃啟原(Chii-Yuan Huang) ； 吳俊良(Jiunn-Liang Wu) ； 林愛惜(Ai-Hsi Lin)

《中華民國耳鼻喉科醫學雜誌》 37卷5期 (2002/08) Pp. 321-329

https://doi.org/10.6286/2002.37.5.321

摘要

背景：依據統計，約有千分之一的新生兒患有先天性兩側聽力障礙。唯有提早診斷，早期治療，才能減低這些幼童將來在語言及學習發展方面的障礙。關於新生兒聽力篩檢，國內過去的相關研究多以單一醫院為主軸，而本研究以各層級的醫療院所之新生嬰兒為研究對象，探討採取自費的模式下，新生兒聽力篩檢的可行性，以期建立一套參考指引，提高國內新生兒聽力篩檢的普及率。另外，我們也針對篩檢過程本身，引起家長心理的衝擊，作評估分析。
方法：由二家醫院與三家婦產科診所共同合作，對於願意自費的新生兒實施耳聲傳射（OAE）聽力篩檢，再以聽性腦幹反應檢查（ABR）確定有無聽力障礙。篩檢過程結束後，以隨機採樣方式，對500名受檢兒的家長，作回郵問卷調查。
結果：自2000年03月至2001年10月研究資料顯示，順產且無轉入加護病房接受照護之新生兒共有5678名，其中有3211名（56.55%）接受聽力篩檢，未通過第一階段（住院期間）耳聲傳射篩檢者佔8.44%（271/3211），出院滿月後，有69.37%（188/271）接受第二階段（門診期間）耳聲傳射篩檢者佔8.44%（271/3211），出院滿月後，有69.37%（188/271）接受第二階段（門診期間）耳聲傳射檢查，在這二階段篩檢過程中有83名新生兒失去連絡，另外，總共有30名嬰兒未通過耳聲傳射篩檢，全部均轉介到本院作聽性腦幹反應檢查，確定有無聽障。最後結果發現有3名嬰兒（1.29/1000）患有感音性聽力障礙。大多數的家長對於全面性新生兒聽力篩檢皆給予正面的肯定。
結論：本研究結合小區域的醫院與診所，採自費篩檢的模式，發現一般民眾是可接受的，有助提高聽障兒的發現比例，減少將來因聽障而衍生的社會問題。

關鍵字

聽力篩檢 ； 新生兒 ； 耳聲傳射

並列摘要

BACKGROUND: Permanent congenital hearing impairment has an incidence of approxi-mately one in every 1000 live births. Early diagnosis and early treatment are essential if the impact of deafness on a child’s development of language and communication skills is to be minimized. Universal neonatal hearing screening (UNHS) programs are the most effective method for early diagnosis. Previous UNHS studies in Taiwan have typically been performed in a single hospital. The presently described model was a community based program that tested the feasibility of screening that utilized otoacoustic emissions. An evaluation of the adverse psychological effects on parents resulting from the screen-ing process itself was also undertaken.
METHODS: The program was undertaken by two hospitals and three obstetric clinics in Tainan city. The screening period spanned March 2000 to October 2001. The subjects were healthy newborns whose parents agreed to pay for otoacoustic emission (OAE) screening. A total of 500 families were randomly chosen to complete the questionnaire.
RESULTS: A total of 5678 healthy neonates were recruited for the study. Of these, 56.55% (3211) were tested and 8.44% (271/3211)failed in the first test. Thirty babies failed in the second test and all babies failing the testing were referred to the same hospi-tal for auditory brainstem response testing. Three babies (1.29/1000) were finally diag-nosed with bilateral sensorineural hearing loss. The program was well regarded by most parents and some suggestions for improvements were made.
CONCLUSION: Concerning cost and utility, there are difficulties in performing a UNHS within Taiwan’s health care system. The study was performed with the cooperation of hospitals and clinics, and was undertaken with a pay-for –screening model. UNHS that uses OAE testing is feasible and well regarded in Tainan city. This model of community based two-stage screening has the potential to significangtly reduce the financial burden of deafness in society.

並列關鍵字

hearing screening ； newborn ； otoacoustic emissions