中文摘要：

目的探讨适合城市流动人口的新生儿听力普遍筛查方案。方法应用瞬态诱发性耳声发射（TEOAE）对北京市上地医院出生的5 484名新生儿进行听力筛查,采用＂两步初筛＋两步复筛＂方案,即初筛未通过者出院前再筛查一次,1月龄复筛未通过者于2月龄时再复筛一次,仍未通过者于3月龄内转诊至儿童听力诊断中心进行听力学诊断和医学评估。结果 2009年4~12月北京市上地医院应筛查5 538人,实际接受初筛5484人,初筛覆盖率99.02%（5484/5538）,其中外地户籍新生儿5368人,占筛查人数的97.88%（5368/5484）。初筛未通过1498人,未通过率27.32%（1498/5484）;1498人中出院前接受二次筛查858人,通过511人,未通过347人。经过两次院内初筛后最终未通过987人（1498-511）,未通过率18.00%（987/5484）。1月龄时实际复筛587人,复筛率59.47%（587/987）,通过472人,未通过115人,转诊率为2.10%（115/5484）;2月龄时实际复筛69人,复筛率60%（69/115）,通过26人,未通过43人,最终转诊率为0.78%（43/5484）。首次初筛和二次初筛后的未通过率,以及一次复筛和二次复筛后的转诊率比较,差异有统计学意义（P〈0.01）。实际接受听力诊断26人,确诊听力损失16人（19耳）,其中双耳轻度3人,单耳轻度10人,单耳极重度3人,听力损失的检出率为2.92‰（16/5484）。结论在城市流动人口中采用＂两步初筛＋两步复筛＂方案进行新生儿听力普遍筛查,可有效提高初筛覆盖率,降低初筛未通过率和转诊率,是一种行之有效的筛查方案。

英文摘要：

Objective To explore a feasible protocol for carrying universal newborn hearing screening in urban mobile population.Methods A two-stage hearing screening protocol consisted of a two-step inpatient screening and two-step outpatient rescreening performed by TEOAE.Newborns who failed the first screening underwent a rescreening before hospital discharge.Infants referred from the inpatient screening underwent an outpatient rescreening at 1 month of age,and those who failed this outpatient rescreening were required to have another rescreening at 2 months of age.Those who failed both screenings would receive a comprehensive audiological evaluation at 3 months of age.Results From April 2009 to December 2009 in Beijing Shangdi Hospital,a total of 5 538 newborns were available for screening,and 5 484 were screened（99.02%） before hospital discharge.1 498 of them（27.32%） failed the first inpatient screening and 858 of them were received a second screening before hospital discharge with 511 passed.A total of 987（18%） failed after the second inpatient screening.587 infants（59.47%） were rescreened at 1 month old,and 115 of them failed with the referral rate at 2.10%（1 15/5 484）.69 infants（60%） were rescreened at 2 months old,and 43 of them failed with the referral rate at 0.78%（43/5 484）.Conclusion Two-step inpatient screening with two-step outpatient rescreening protocol can effectively improve the coverage rate and reduce the referral rate,which is an effective hearing screening protocol in urban floating population.