<span style="background-color: rgb(255, 255, 255);"><span style="font-family: 宋體; font-size: 10pt;"> </span><span style="font-size:16px;"><span style="font-family: 宋體;"> </span><span style="font-family: 宋體;"><span style="font-family: 宋體;">聽(tīng)力問(wèn)題,是全球面臨的一個(gè)非常嚴(yán)峻的問(wèn)題,及早預(yù)防就顯得比較重要了,因此,父母要及早的做好新生兒的聽(tīng)力篩查。年輕奶爸奶媽應(yīng)該提前了解如下幾方面的知識(shí)。</span></span></span></span></p><p><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;"> 新生兒聽(tīng)力篩查,是指通過(guò)耳聲發(fā)射、自動(dòng)聽(tīng)性腦干反應(yīng)和聲阻抗等電生理學(xué)檢測(cè),在新生兒出生后自然睡眠或安靜的狀態(tài)下進(jìn)行的客觀、快速和無(wú)創(chuàng)的檢查。</span></span></span></p><p style="text-align: center;"><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;"><img src="/upfiles/201804291011438168.jpg" alt="" /><br /></span></span></span></p><p><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;">篩查時(shí)間</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;"><span style="font-family:宋體;">一</span></span><span style="font-family: 宋體;">.</span><span style="font-family: 宋體;"><span style="font-family:宋體;">初步篩查過(guò)程(初篩):即新生兒生后</span></span><span style="font-family: 宋體;">3-5</span><span style="font-family: 宋體;"><span style="font-family:宋體;">天住院期間的聽(tīng)力篩查。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;"><span style="font-family:宋體;">二</span></span><span style="font-family: 宋體;">.</span><span style="font-family: 宋體;"><span style="font-family:宋體;">第</span></span><span style="font-family: 宋體;">2</span><span style="font-family: 宋體;"><span style="font-family:宋體;">次篩查過(guò)程(復(fù)篩):即出生</span></span><span style="font-family: 宋體;">42</span><span style="font-family: 宋體;"><span style="font-family:宋體;">天內(nèi)的嬰兒初篩沒(méi)</span></span><span style="font-family: 宋體;">“</span><span style="font-family: 宋體;"><span style="font-family:宋體;">通過(guò)</span></span><span style="font-family: 宋體;">”</span><span style="font-family: 宋體;"><span style="font-family:宋體;">;或初篩</span></span><span style="font-family: 宋體;">“</span><span style="font-family: 宋體;"><span style="font-family:宋體;">可疑</span></span><span style="font-family: 宋體;">”</span><span style="font-family: 宋體;"><span style="font-family:宋體;">;甚至初篩已經(jīng)</span></span><span style="font-family: 宋體;">“</span><span style="font-family: 宋體;"><span style="font-family:宋體;">通過(guò)</span></span><span style="font-family: 宋體;">”</span><span style="font-family: 宋體;"><span style="font-family:宋體;">,但屬于聽(tīng)力損失高危兒如重癥監(jiān)護(hù)病房患兒,需要進(jìn)行聽(tīng)力復(fù)篩。</span></span></span></p><p><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;">診斷性評(píng)估</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;"><span style="font-family:宋體;">未通過(guò)復(fù)篩的嬰幼兒,都應(yīng)在</span></span><span style="font-family: 宋體;">3</span><span style="font-family: 宋體;"><span style="font-family:宋體;">月齡接受聽(tīng)力學(xué)和醫(yī)學(xué)評(píng)估,確保在</span></span><span style="font-family: 宋體;">6</span><span style="font-family: 宋體;"><span style="font-family:宋體;">月齡內(nèi)確定是否存在先天性或永久性聽(tīng)力損失,以便實(shí)施干預(yù)。即復(fù)篩未通過(guò)的患兒應(yīng)由聽(tīng)力檢測(cè)機(jī)構(gòu)進(jìn)行耳鼻咽喉科檢查及聲導(dǎo)抗、耳聲發(fā)射、聽(tīng)性腦干誘發(fā)電位檢測(cè)、行為測(cè)聽(tīng)及其它相關(guān)檢查,必要時(shí)并進(jìn)行醫(yī)學(xué)和影像學(xué)評(píng)估,做出診斷。對(duì)具有聽(tīng)力損失高危因素的兒童,應(yīng)根據(jù)可能發(fā)生的遲發(fā)性聽(tīng)力損失狀況,制定個(gè)體化的聽(tīng)力再評(píng)估的時(shí)間和次數(shù)。對(duì)于通過(guò)新生兒聽(tīng)力篩查但具有聽(tīng)力損失高危因素的嬰幼兒,至少</span></span><span style="font-family: 宋體;">3</span><span style="font-family: 宋體;"><span style="font-family:宋體;">歲內(nèi)每</span></span><span style="font-family: 宋體;">6</span><span style="font-family: 宋體;"><span style="font-family:宋體;">個(gè)月進(jìn)行</span></span><span style="font-family: 宋體;">1</span><span style="font-family: 宋體;"><span style="font-family:宋體;">次聽(tīng)力隨訪,若可疑有聽(tīng)力損失,應(yīng)及時(shí)進(jìn)行聽(tīng)力學(xué)評(píng)估。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;">1</span><span style="font-family: 宋體;"><span style="font-family:宋體;">、聽(tīng)損傷確診</span></span></span></p><p><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;">新生兒聽(tīng)力篩查、診斷和干預(yù),這是一完整的聽(tīng)力康復(fù)系統(tǒng)工程。干預(yù)措施為最后環(huán)節(jié),是顯示先天性耳聾康復(fù)成果的關(guān)鍵。采用何種方法以及何時(shí)進(jìn)行干預(yù),對(duì)患兒的聽(tīng)力、言語(yǔ)及語(yǔ)言康復(fù)很重要。干預(yù)包括醫(yī)學(xué)干預(yù)、聽(tīng)力補(bǔ)償或重建、以及聽(tīng)功能訓(xùn)練和語(yǔ)言康復(fù)訓(xùn)練。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;">2.</span><span style="font-family: 宋體;"><span style="font-family:宋體;">聽(tīng)力補(bǔ)償或重建</span></span></span></p><p><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;">聽(tīng)力補(bǔ)償或重建主要包括助聽(tīng)器選配和人工耳蝸植入。</span></span></span></p><p><span style="font-family: 宋體;"><span style="font-family:宋體;"><span style="font-size:16px;">助聽(tīng)器選配:永久性感音神經(jīng)性聽(tīng)力損失患兒選配助聽(tīng)器,聽(tīng)力障礙的程度一般在中度至重度,甚至有專家主張輕度聽(tīng)力障礙也需選配助聽(tīng)器,進(jìn)行聽(tīng)力矯正,單側(cè)聽(tīng)力損失者也可以<a href="http://cxji.cn/zhutingqiInfo-101066.html"><strong>選配助聽(tīng)器</strong></a>。雙側(cè)聽(tīng)力損失應(yīng)選配雙側(cè)助聽(tīng)器。雙耳選配優(yōu)點(diǎn)是,有利于分辨聲源,提高聲源定向能力,整合效應(yīng)好,聽(tīng)聲音的響度增加等。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;"><span style="font-family:宋體;">人工耳蝸植入:人工耳蝸植入裝置是一種模擬人耳蝸功能的轉(zhuǎn)換器。它將聲音信號(hào)通過(guò)言語(yǔ)處理器轉(zhuǎn)變成電信號(hào),傳入內(nèi)耳的電極,直接興奮聽(tīng)神經(jīng),從而產(chǎn)生聽(tīng)覺(jué)。人工耳蝸裝置主要分</span></span><span style="font-family: 宋體;">2</span><span style="font-family: 宋體;"><span style="font-family:宋體;">大部分:植入部分(包括接收裝置和多道電極)和外接部分(包括耳機(jī)、發(fā)射器、言語(yǔ)處理器等)。對(duì)雙側(cè)重度或極重度感音神經(jīng)性聽(tīng)力障礙患兒,使用助聽(tīng)器</span></span><span style="font-family: 宋體;">3<span style="font-family:Calibri;">—</span><span style="font-family:宋體;">6</span></span><span style="font-family: 宋體;"><span style="font-family:宋體;">個(gè)月無(wú)明顯效果,</span></span><span style="font-family: 宋體;">10</span><span style="font-family: 宋體;"><span style="font-family:宋體;">個(gè)月左右進(jìn)行人工耳蝸術(shù)前評(píng)估,建議盡早實(shí)施人工耳蝸植人手術(shù)。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;">3</span><span style="font-family: 宋體;"><span style="font-family:宋體;">.聽(tīng)功能訓(xùn)練和言語(yǔ)</span></span><span style="font-family: 宋體;">—</span><span style="font-family: 宋體;"><span style="font-family:宋體;">語(yǔ)言康復(fù)訓(xùn)練。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;"><span style="font-family:宋體;">患兒經(jīng)助聽(tīng)器選配和人工電子耳蝸植入聽(tīng)力矯正之后,需進(jìn)行聽(tīng)功能訓(xùn)練和言語(yǔ)</span></span><span style="font-family: 宋體;">—</span><span style="font-family: 宋體;"><span style="font-family:宋體;">語(yǔ)言康復(fù)訓(xùn)練。需要有醫(yī)生、聽(tīng)力學(xué)家、言語(yǔ)</span></span><span style="font-family: 宋體;">—</span><span style="font-family: 宋體;"><span style="font-family:宋體;">語(yǔ)言治療師、特殊教育者和心理學(xué)家參加。與患兒建立長(zhǎng)期關(guān)系來(lái)支持兒童的聽(tīng)力和語(yǔ)言的發(fā)育相當(dāng)重要,使聾兒患者能聽(tīng)到聲音,并能理解講話。新生兒聽(tīng)力篩查必不可少,做到早發(fā)現(xiàn)、早干預(yù)、早康復(fù)。</span></span></span></p><p><span style="font-size:16px;"><span style="font-family: 宋體;"> </span><span style="font-family: 宋體; color: rgb(255, 0, 0);"> </span><span style="color: rgb(51, 51, 51);"><span style="font-family: 宋體;"> </span><span style="font-family: 宋體;"><span style="font-family:宋體;">年輕的爸媽一定不要忽視,如果遇到聽(tīng)力問(wèn)題也不要回避,可能嬰幼兒期,孩子還不會(huì)講話,似乎聽(tīng)力的問(wèn)題影響不是特別明顯,但是當(dāng)孩子到了</span></span><span style="font-family: 宋體;">5</span><span style="font-family: 宋體;"><span style="font-family: 宋體;">歲以上,感覺(jué)孩子還是跟嬰兒一定,什么都聽(tīng)不懂估計(jì)爸媽們都著急了,但是這個(gè)時(shí)候可能錯(cuò)過(guò)了最佳治療時(shí)機(jī)。</span></span></span></span></p>" />