目的 探讨早产儿听力筛查未通过的高危因素。方法 选择2020年1月1日至12月31日在合肥市妇幼保健计划生育服务中心新筛中心听力筛查门诊进行首次筛查的551例早产儿为调查对象,对其进行瞬态诱发性耳声发射(TEOAE)和自动听性脑干反应(AABR)筛查,同时采用自制的早产儿听力筛查情况调查表,收集产妇孕期情况及早产儿出生后临床资料,采用χ²单因素分析和logistic回归多因素分析早产儿听力筛查未通过的高危因素。结果 TEOAE与AABR联合筛查共筛查551人,未通过者132人,未通过率为24.0％。单因素分析显示:家庭住址、母亲分娩时年龄、是否有耳廓或外耳道畸形、听力障碍家族史、检测时月龄、孕周、矫正胎龄等方面差异有统计学意义(P值均＜0.05)。多因素分析结果显示:家庭住址为农村(OR=1.931,95％CI:1.178~3.165)、有耳廓或外耳道畸形(OR=7.524,95％CI:1.193~47.439)、有听力障碍家族史(OR=4.974,95％CI:1.348~18.354)是早产儿听力筛查未通过的危险因素,以早产儿检测时月龄≤1个月为参照,>1且≤2个月(OR=2.847,95％CI:1.090~7.433)、>2且≤3个月(OR=6.359,95％CI:2.250~17.971)、＞3个月(OR=6.750,95％CI:2.343~19.449)组是早产儿听力筛查未通过的危险因素。结论 针对早产儿的听力筛查提倡采用TEOAE和AABR联合应用筛查。早产儿听力未通过率较高,多种因素影响早产儿听力筛查未通过情况。

Objective To explore the risk factors for failing hearing screening in premature infants. Methods From January 1,2020 to December 31,2020,551 premature infants who underwent the first screening in the hearing screening clinic of the Newborn's Diseases Screening Center of Hefei Maternity & Child Health Center were selected as the investigation objects.Transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (AABR) screening were performed on them.Meanwhile,the self-made hearing screening questionnaire of premature infants was used to collect their mothers' pregnancy and post-birth clinical data.Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of premature infants failing hearing screening. Results A total of 551 patients were screened by TEOAE combined with AABR,and 132 failed,with a failure rate of 24.0％.Univariate analysis showed that there were statistically significant differences in home address,mother's age at delivery,whether there were auricle or external auditory canal malformation,family history of hearing impairment,months at detection,gestational age and corrected gestational age (P<0.05).The results of multi-factor analysis showed that rural home address (OR=1.931,95％CI:1.178-3.165),auricle or external auditory canal malforming (OR=7.524,95％CI:1.193-47.439),and family history of hearing impairment (OR=4.974,95％CI:1.348-18.354)were risk factors for hearing screening failure of preterm infants.Taking the age of premature infants≤1 month as reference,the three month age groups >1 and≤2 months (OR=2.847,95％CI:1.090-7.433),>2 and ≤3 months (OR=6.359,95％CI:2.250-17.971) and >3 months (OR=6.750,95％CI:2.343-19.449)were risk factors for premature infants failing hearing screening. Conclusion The combined application of TEOAE and AABR is recommended for hearing screening of premature infants.Premature infants have a high rate of hearing failure,and multiple factors affect the failure rate of hearing screening for premature infants.