番禺区学龄前儿童（3~6岁）听力分析及临床听力管理模式的研究

吴盾 欧满灿 黄绮玲

【摘要】 目的：探讨番禺区学龄前儿童（3～6岁）听力分析及临床听力管理模式。方法：选取2017年1月-2018年1月本院儿童保健科负责常规体检的30家幼儿园中的3～6岁学龄前儿童7 277例作为研究对象。分析所有入组儿童的听力筛查、复诊转诊及治疗情况，同时对这部分儿童的听力管理实施“闭环式管理”模式。与2016年度的7 156例兒童听力异常发病率及复发率情况进行比较。结果：所有7 277例儿童中，6 872例（94.4%）通过听力初筛检查;405例听力初筛检查未通过儿童中，342例（84.4%）儿童未通过复查后转诊;342例转诊儿童中，分泌性中耳炎35例（10.2%），耵聍栓塞113例（33.0%），手术干预72例（21.1%），药物保守治疗122例（35.7%）。2017年度实施闭环式管理后，学龄前儿童听力异常发病率及复发率均明显低于2016年同期（P<0.05）。结论：本次7277例学龄前儿童（3～6岁）共确诊342例（4.7%）听力损失儿童，主要导致因素为分泌性中耳炎及耵聍栓塞;给予在园学龄前儿童实施闭环式管理能够有效降低听力异常的发病率及复发率。

【关键词】 学龄前儿童; 3～6岁; 听力筛查; 听力管理模式; 闭环式管理

【Abstract】 Objective：To explore the auditory analysis and clinical auditory management model of preschool children（3-6 years old）in Panyu District.Method：7 277 preschool children aged 3-6 years in 30 kindergartens for routine physical examination in the department of child health of our hospital from January 2017 to January 2018 were selected as the subjects of study.Hearing screening，referral and treatment were analyzed for all the children enrolled in the study.At the same time，a closed-loop management model was implemented for hearing management of these children.The incidence and recurrence rates of hearing abnormalities were compared with that of 7 156 children in 2016.Result：Of all 7277 children，6872 cases（94.4%）passed the hearing screening test.Of 405 children failed to pass the hearing screening，342 cases（84.4%）failed to pass the re-examination were referred to the hospital.Of the 342 children referred，35 cases（10.2%）with secretory otitis media and 113 cases（33.0%）with cerumen embolism，72 cases（21.1%）with surgical intervention and 122 cases（35.7%）were treated with medicine conservatively.After closed-loop management in 2017，the incidence and recurrence rate of hearing disorders in preschool children were significantly lower than those in the same period in 2016（P<0.05）.Conclusion：A total of 342 cases（47.0%）with hearing loss were diagnosed in 7 277 preschool children（3-6 years old）.The main causes were secretory otitis media and cerumen embolism.Closed-loop management can effectively reduce the incidence and recurrence rate of hearing disorders in preschool children in kindergartens.

【Key words】 Preschool children; 3-6 years old; Hearing screening; Hearing management model;Closed-loop management

First-authors address：Hexian Memorial Hospital of Panyu District in Guangzhou City，Guangzhou 511400，China

doi：10.3969/j.issn.1674-4985.2019.16.020

3～6岁阶段的儿童正处于学龄前阶段，这一阶段属于儿童语言发育的一个最佳的及黄金时期。如果在此时儿童出现听力损失，就会导致对儿童的身心健康、学习、语言带来十分严重的不良影响[1]。即便目前已经在全国范围内普及了有关新生儿的听力筛查工作，但是仍有少部分的新生儿在通过听力筛查后随着成长出现迟发性的听力损失现象。特别是单侧或者是轻度及中度的听力损失，十分容易被家长及医生所忽视，所以，对学龄前儿童进行及时有效的听力保健具有十分积极的重要意义，能够帮助早期及时发现相关的听力损失情况并进行早期干预，以改善儿童的预后[2]。……