郑州地区2018—2020年794例人工耳蜗植入患者特征

Characteristics of 794 Patients with Cochlear Implantation in Zhengzhou from 2018 to 2020

目的回顾性分析郑州地区794例人工耳蜗植入患者的特征。方法收集2018年1月至2020年12月河南省人民医院收治的794例人工耳蜗植入患者的病历资料,包括患者性别、年龄、手术年龄、耳聋病程、术后并发症、术前影像学检查结果、术后6个月植入效果等。结果 2018—2020年,人工耳蜗植入数量呈逐年增长的趋势[2018年139例(17.51%),2019年257例(32.37%),2020年389例(49.92%)](P<0.05)。国产人工耳蜗的植入数量[563例(70.91%)]高于进口人工耳蜗数量[231例(29.09%)](P<0.05)。不同年份患者性别比较,差异无统计学意义(P>0.05)。年龄最小10个月,最大65岁,耳聋时长最短8个月,最长25 a。语前聋患者[453例(57.05%)]较语后聋患者[341例(42.95%)]多(P<0.05),手术年龄[(6.56±1.60)岁]小于语后聋患者[(23.12±3.26)岁](P<0.05)。颞骨CT检查显示,合并异常144例,占总人数的18.14%,共合并异常情况195次,其中中耳炎52次,所占比率最高(36.11%)。头颅MR检查显示,合并脑形态异常308例,占总人数的38.79%,脑白质异常发生率最高,以侧脑室周围异常[155次(50.32%)]最常见。有14例患者出现不良反应,总发生率为1.76%。术后6个月,纯音听力水平、听觉行为分级标准分级得分及言语可懂度分级标准得分均较植入前升高(P<0.05)。结论郑州地区人工耳蜗植入患者数量逐年增加,语后聋患者手术年龄高于语前聋患者;术前头颅MR检查异常患者比率较高,颞骨CT检查对手术有一定临床意义;国产人工耳蜗的植入已超过进口人工耳蜗,且术后听力及言语康复均能获得满意的效果。

Objective To etrospective analyze the characteristics of 794 patients with cochlear implantation in Zhengzhou from 2018 to 2020.Methods The disease data of patients with cochlear implant admitted to Henan Provincial People’s Hospital from January 2018 to December 2020 were collected for descriptive analysis,including patients’gender,age,surgical age,deafness course,postoperative complications,preoperative imaging examination results and implant effect 6 months after surgery.Results From 2018 to 2020,the number of artificial cochlear implants was increasing year by year[139 cases(17.51%)in 2018,257 cases(32.37%)in 2019,389 cases(49.92%)in 2020](P<0.05).The number of domestic cochlear implants[563 cases(70.91%)]was higher than that of imported ones[231 cases(29.09%)](P<0.05).There was no significant difference in gender among patients in different years(P<0.05).The minimum age was 10 months and the maximum age was 65 years.The minimum duration of deafness was 8 months and the maximum duration of deafness was 25 years.The radio of patients with pre-speech deafness[453 cases(57.05%)]were higher than that of patients with post speech deafness[341 cases(42.95%)](P<0.05).The surgery age of patients with pre-speech deafness[(6.56±1.60)years old]was younger than that of patients with post speech deafness[(23.12±3.26)years old](P<0.05).CT examination of temporal bone showed that 144 cases were complicated with abnormalities,accounting for 18.14%,and a total of 195 abnormal conditions were combined,52 times of otitis media,accounting for the highest rate(36.11%).Cranial MR examination showed that 308 cases were complicated with brain morphological abnormalities,accounting for 38.79%of the total number.The frequency of white matter abnormalities was the highest,and the abnormalities around the lateral ventricle[155 times(50.32%)]were the most common.There were 14 cases with adverse reactions,and the total incidence was 1.76%.After 6 months of implantation,the pure tone hearing level,the categories of auditory performance score of hearing ability and the speech intelligibility rate score of speech intelligibility were higher than those of before implantation(P<0.05).Conclusion The number of cochlear implant patients in Zhengzhou has increased year by year,and the operative age of patients with post-speech deafness are older than that of patients with pre-speech deafness.The proportion of patients with cranial MR examination before operation is higher,and CT examination of temporal bone has certain clinical significance for operation.The number of domestic cochlear implants has exceeded that of imported ones,and postoperative hearing and speech rehabilitation are satisfactory.