单侧聋不同干预方式效果的系统评价与Meta分析

Systematic Review and Meta-analysis of the Effects of Different Interventions on Unilateral Deafness

目的系统评价单侧聋不同干预措施的效果。方法检索中国知网、万方、Web of science、PubMed、Cochrance Library等数据库及中国临床试验注册中心,搜索有关单侧聋分别采用信号对侧传输系统(CROS)、骨传导装置(BCD)、人工耳蜗植入(CI)干预方式效果的临床试验研究,检索时限为各数据库建库以来至2022年10月,由2名评价员独立筛选文献、提取资料和文献质量评估后,采用Rev Man 5.3软件进行Meta分析。结果共纳入14篇研究547例单侧聋患者,Meta分析结果示:①噪声下言语:三种干预方式在SssdNnh(目标信号位于患侧、噪声位于正常侧)方位下结果与未干预组有统计学差异,其余方位没有统计学差异;②声源定位:CI干预组优于未干预组,有统计学差异,BCD干预组与对照组没有统计学差异,CROS干预组比未干预组差,有统计学差异;③耳鸣量表得分:CI和BCD干预与对照组有统计学差异,CROS干预没有统计学差异;④SSQ得分:三种干预方式均优于对照组,有统计学差异。结论人工耳蜗植入对单侧聋患者在噪声下言语识别、声源定位、耳鸣缓解及日常听能改善均有明显的改善作用,BCD和CROS干预在特定的生活场景下也有一定的改善作用。

Objective To systematically study the effects of different interventions on unilateral deafness.Methods The CNKI,Wanfang Data,Web of science,Pubmed,Cochrane Library and Chinese Clinical Trial Regisrty were electronically searched to collect clinical trials on the effects of signal contralateral transmission system(CROS),bone conduction device(BCD)and cochlear implantation(CI)interventions on unilateral deafness.The retrieval time limit was from the establishment of each database to October 2022.Two reviewers independently screened literature,extracted data,and assessed the risk bias of included studies.Then,meta-analysis was performed by Rev Man 5.3 software.Results A total of 14 clinical trials involving 547 patients were included.The results of meta-analysis:①Speech perception in noise:The results of the three intervention methods in the SssdNnh position were statistically different from those of the non-intervention group,and there was no statistical difference in the other positions.②Sound source localization:CI intervention results were significantly better than those of the non-intervention group.The results of BCD intervention were not significantly different from those of the control group.CROS intervention results were significantly worse than those of non-intervention group.③Tinnitus scale scores:The results of CI and BCD intervention were significantly different from those of control group,and CROS intervention had no significant difference.④SSQ scores:There were significant differences between the three intervention methods and the control group,and they were better than the control group.Conclusion Cochlear implant can significantly improve speech recognition,sound source localization,tinnitus relief and daily hearing improvement under noise,and BCD and CROS intervention can also provide improvement in specific life scenarios.