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  本文關鍵詞： 多頻穩(wěn)態(tài) 人工耳蝸植入 神經(jīng)反應遙測 術前評估　出處：《安徽醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的多頻穩(wěn)態(tài)聽覺誘發(fā)電位（ASSR）是目前重度及極重度耳聾患者行診斷、術前常規(guī)檢查項目之一，對殘余聽力具有良好評估效果。神經(jīng)反應遙測技術(neuralresponse telemetry, NRT)是一種記錄電誘發(fā)聽神經(jīng)復合動作電位(electricallyevokedcompound action potential, ECAP)的客觀測試,，應用于人工耳蝸植入術的術中檢測和術后開機，是確定電刺激閾值和最大刺激閾值的重要參考標準。本文通過分析25例澳大利亞人工耳蝸植入者的檢查結果，探討術前ASSR與術后神經(jīng)反應遙測之間的相關性的研究。 方法分析2005-2011年4月期間在我院行人工耳蝸植入術的25例澳大利亞人工耳蝸植入者在頻率500HZ、1KHZ、2KHZ、4KHZ的ASSR檢測結果，對其術后第1、3、6月開機、調(diào)試時選取第5、10、15、20電極行神經(jīng)反應遙測(neuralresponse telemetry, NRT)檢測，測定ASSR、電誘發(fā)聽神經(jīng)復合動作電位(ECAP)、主觀閾值(T-levels)和主觀最大舒適強度(C-levels)，根據(jù)術耳術前ASSR在500Hz和2000Hz有無引出將數(shù)據(jù)分為兩組，兩者之一可引出或者兩者均可引出分為A組，兩個頻率都沒有引出分為B組，將兩組術后第20和10通道的NRT的主觀閾值T結果對比做統(tǒng)計學分析。 結果 1.術后聽力聽閾調(diào)試結果為 A組術后第1、3、6月的第20通道的T值平均值分別為149.42dB，150.70dB，151.89dB。第10通道的T值分別為157.24dB，158.53dB，159.75dB。 B組術后第1、3、6月的第20通道T值平均值分別為151.12dB，151.84dB，153.25dB。第10通道的T值分別為158.69dB，161.20dB，163.98dB。 通過SPASS13.0軟件用t檢驗分析比對，發(fā)現(xiàn)術后1月和3月、6月時在通道10和通道20的T值A組值均比B組較低，差異均有統(tǒng)計學意義。 2.電話隨訪結果 今年2月份進行末次電話隨訪時，，有12例已進入普通小學、幼兒園上學，13例仍在言語康復學校訓練，均可和家人正常交流,家屬滿意度優(yōu)。 結論術前多頻穩(wěn)態(tài)與術后神經(jīng)反應遙測具有良好的相關性，對預行人工耳蝸植入術患者術前進行多頻穩(wěn)態(tài)檢測，可以對其術后聽力反應具有良好的評估，可作為術耳選擇參考條件之一。
[Abstract]:Objective Multi-frequency steady-state auditory evoked potential (ASSRS) is one of the routine preoperative examinations for the diagnosis of severe and extremely severe deafness. Neural response telemetry (NRTT) is an objective test for recording electrically-evoked compound action potential (ECAP), which is used for the intraoperative detection and operation of cochlear implants. It is an important reference standard to determine the electrical stimulation threshold and the maximum stimulation threshold. By analyzing the results of 25 Australian cochlear implants, the correlation between preoperative ASSR and postoperative nerve response telemetry was studied. Methods the ASSR results of 25 Australian cochlear implants who underwent cochlear implants in our hospital from April 2005 to 2011 were analyzed at the frequency of 500HZ1KHZ2KHZ2KHZ2KHZ 4KHZ. The first operation was performed on the 3rd day after operation, and the operation was performed on June. Nerve response telemetry and neuralresponse telemetrymetry (NRTs) were performed at the 5th 10h 1520 electrode during debugging. ASSRs, electrically evoked auditory nerve complex action potentials (ECAPs), subjective threshold values (T-level) and subjective maximum comfort intensity (C-level sn) were measured. The data were divided into two groups according to whether the preoperative ASSR was obtained at 500Hz and 2000Hz. One of them can be induced or both can be divided into A group and neither frequency is divided into B group. The subjective threshold T results of NRT in the 20th and 10th channels after operation in both groups were compared and analyzed statistically. Results. 1. The results of hearing threshold debugging after operation are as follows: 1. In group A, the mean T values of the 20th channel were 149.42 dB ~ 150.70 dB ~ 151.89 dB and 157.24 dB ~ 158.53 dB ~ 159.75 dB, respectively. In group B, the mean T values of the 20th channel were 151.12 dB1, 151.84 dB and 153.25 dB, respectively, and the T values of the 10th channel were 161.20 dB and 163.98 dB, respectively. The T-value of group A was lower than that of group B on January, March and June by SPASS13.0 software, and the difference was statistically significant between group A and group B. the T value of group A was significantly lower than that of group B on January, March and June. 2. Telephone follow-up results. At the last telephone follow-up in February this year, 12 cases had entered ordinary primary school, 13 cases in kindergarten were still training in speech rehabilitation school, they could communicate with their families normally, and the satisfaction of the families was excellent. Conclusion there is a good correlation between preoperative multifrequency steady-state and postoperative nerve response telemetering. The multifrequency steady-state detection before cochlear implantation can be used to evaluate the postoperative hearing response of cochlear implants. It can be used as one of the reference conditions for ear selection.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R764

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