目的探讨新生儿听力障碍的发生情况及高危因素,以便早期干预治疗。方法采用耳声发射仪和(或)自动听性脑干反应对28043例新生儿进行听力筛查及复查,复筛未通过者利用脑干听觉诱发电位仪进行听力障碍诊断。结果3年总出生新生儿28405例,可筛总数28369例,实际筛查28043例,其中3201例因各种原因在新生儿科治疗(高危组),余无明确高危因素(正常组)。初筛率98.85%,初筛未通过率6.39%(1792/28043);应复查1792例,实际复查1183例,复查率66.01%,复查未通过率13.01%(154/1183);进行诊断患儿150例,其中70例出现不同程度听力损伤,听力损伤的发生率为2.4‰(70/28043),其中轻度损伤29例(41.4%),中度损伤25例(35.7%),重度损伤18例(12.9%),极重度损伤7例(10.0%)。正常组听力损伤检出率1.89‰,高危组检出率1.03%,高危儿听力损伤的发生率(33/3201)明显高于正常新生儿,两者比较有显著性差异(P﹤0.05)。分析33例高危儿发现早产、窒息、出生缺陷等可能与听力损伤有关。结论对所有新生婴儿应常规进行新生儿听力筛查,加强宣教,增加复筛率,早期发现,早期治疗。耳声发射仪联合自动听性脑干反应能提高高危儿听力损伤的诊断率。听力损伤的发生病因复杂,在将高危因素的患儿列为重点筛查对象的同时,对所有婴儿均应进行必要的监测,以减少儿童永久性听力损伤的发生率。 Objective To investigate the incidence of neonatal hearing disorders and risk factors for early intervention. Methods A total of 28043 neonates underwent audiological screening and review with otoacoustic emission apparatus and / or automatic auditory brainstem response. The patients who failed to pass the screening were diagnosed with hearing loss by brainstem auditory evoked potentials. Results A total of 28,405 newborn babies were born in 3 years, 28,369 were screened and 28,043 were actually screened. Among them, 3201 were neonatal (high risk group) and no clear risk group (normal group) for various reasons. The first screening rate was 98.85%, the first screening failed rate of 6.39% (1792/28043); 1792 cases should be reviewed, the actual review of 1183 cases, the review rate of 66.01%, failed to pass the inspection rate of 13.01% (154/1183); diagnosis of children 150 cases, of which 70 cases showed varying degrees of hearing impairment, the incidence of hearing loss was 2.4 ‰ (70/28043), of which mild injury in 29 cases (41.4%), moderate injury in 25 cases (35.7%), severe injury Cases (12.9%), extremely severe injury in 7 cases (10.0%). The detection rate of hearing loss was 1.89 ‰ in normal group and 1.03% in high risk group, and the incidence of hearing impairment in high risk group (33/3201) was significantly higher than that of normal newborn (P <0.05). Analysis of 33 cases of high-risk children found premature birth, asphyxia, birth defects may be related to hearing impairment. Conclusion All newborn infants should routinely conduct neonatal hearing screening, strengthen education, increase the rate of screening, early detection, early treatment. Otoacoustic transmitter combined with automatic auditory brainstem response can improve the diagnostic rate of hearing-impaired children. The causes of hearing impairment are complicated. When the children with high risk factors are selected as the key screening target, all infants should be monitored as necessary to reduce the incidence of permanent hearing impairment in children.