陕北地区56例人工耳蜗植入患者的临床特点分析

Clinical Characteristics of 56 Patients with Cochlear Implants in Northern Shaanxi

目的总结陕北地区某院人工耳蜗植入患者的临床特点、术后并发症和听觉言语康复效果,为经济欠发达地区开展人工耳蜗相关工作提供参考。方法回顾性分析56例于陕西省延安大学附属医院行人工耳蜗植入手术患者的临床资料,对所有患者采用声导抗测试、纯音测听/小儿行为测听、畸变产物耳声发射(DPOAE)、听性脑干诱发反应(ABR)、稳态诱发反应(ASSR)评估其听力水平,分别于术后3、6个月采用助听听阈、听觉行为分级(CAP)和言语可懂分级(SIR)评估其听觉言语康复效果。结果患者年龄跨度大(10月~50岁);双耳重度和/或极重度感音神经性听力损失;耳蜗来源以基金会项目支持(62.50%,35/56)和自费(30.36%,17/56)为主;植入侧以右侧植入为主(80.36%,45/56);耳蜗畸形者占30.36%(17/56);大前庭水管综合征者占33.93%(19/56);术后并发症的发生率为7.14%(4/56);所有患者CI术后3个月与6个月的CAP、SIR评分均显著提高(P<0.05)。结论陕北地区听障患者对人工耳蜗植入有一定需求,听觉言语康复效果随人工耳蜗植入时间的延长而提高。

Objective To summarize the clinical characteristics, postoperative complications and the effect of auditory and speech rehabilitation of patients with cochlear implants in a hospital in Northern Shaanxi Province, and to provide reference for the work related to cochlear implants in underdeveloped areas. Methods The clinical data of 56 patients with cochlear implantation in the Affiliated Hospital of Yan’an University in Shaanxi Province were analyzed retrospectively. The hearing level was assessed by acoustic immittance test, pure tone audiometry/children’s behavior audiometry, DPOAE, ABR and ASSR at 3 and 6 months after operation, The effects of auditory speech rehabilitation were evaluated by categories of auditory performance(CAP) and speech intelligibility rating(SIR). Results The age span of patients was large(10 Months to 50 years old);severe and/or very severe sensorineural hearing loss in both ears;cochlear resources mainly come from foundation project support(62.50%, 35/56) and self expense(30.36%, 17/56);right side implantation(80.36%, 45/56);cochlear malformation(30.36%), vestibular aqueduct enlargement(33.93%), and postoperative complications(7.14%);the scores of CAP and SIR of all patients at 3 and 6 months after CI were significantly improved(P<0.05). Conclusion Patients with hearing impairment in non economically developed areas have a certain demand for CI, and the effect of auditory speech rehabilitation increases with the extension of cochlear implant time.