本文選題：畸變產物耳聲發(fā)射　切入點：聽性腦干反應　出處：《福建醫(yī)科大學》2011年碩士論文　論文類型：學位論文

【摘要】：目的: 通過對聽力學檢查表現(xiàn)為DPOAE部分異常而聽性腦干反應ABR無波反應的患者行人工耳蝸術后NRT檢測中ECAP的研究來探討此類聽力學特征是否為耳蝸伴有蝸后性聾的診斷依據,用MAIS評價這類患者人工耳蝸植入的效果。 方法: 采取回顧性病例對照研究的方法,在2002-2010年行人工耳蝸植入的226名患者中選取符合納入和排除標準的DPOAE部分異�；颊�18例和DPOAE完全異常患者18例。分析DPOAE的引出情況,比較兩組ECAP未引出率、ECAP閾值,及MAIS得分。 結果: 1、研究組A中患者的DPOAE有3個、4個及5個頻率引出,引出的頻率主要集中在中、高頻區(qū)。 2、各電極ECAP未引出數(shù)比較,術中2號電極A組高于B組,差異有統(tǒng)計學意義(P0.05)�？偟腅CAP未引出數(shù)比較,術中、開機、復診及三次檢測A組均高于B組,差異有統(tǒng)計學意義(P0.05)。按直彎電極構成校正三次總ECAP未引出率,A組大于B組,差異有統(tǒng)計學意義(P0.05)。A、B兩組組內不同時間ECAP檢出率比較,其中術中與開機、術中與復診所得P0.05差異均有統(tǒng)計學意義,但開機與復診P0.05差異均無統(tǒng)計學意義。各電極ECAP閾值比較,術中22號電極、復診2、6、18、22號電極A組大于B組差異有統(tǒng)計學意義(P0.05)。 3、MAIS得分比較,A、B兩組3-10題得分術后均高于術前,差異有統(tǒng)計學意義(P0.05)。A、B兩組術后得分比較,差異無統(tǒng)計學意義P0.05。 4、A1與B1、A2與B2、A與B的年齡比較,差異無統(tǒng)計學意義P0.05。 結論: DPOAE部分異�；颊叨佂饷毎胁∽�,但在中高頻對應的耳蝸區(qū)域仍殘存部分有功能的外毛細胞。在人工耳蝸植入候選患者中可能存在耳蝸與蝸后病變并存性耳聾,DPOAE部分異常(中高頻正常)且ABR無波反應是這一類患者的診斷依據之一。本研究中DPOAE部分異常且ABR無波反應的患者其蝸后病變部位在螺旋神經節(jié)細胞或聽神經或兩者病變共存。本研究中DPOAE部分異常且ABR無波反應不可看做人工耳蝸植入的禁忌癥,這類患者人工耳蝸植入效果良好,適宜行人工耳蝸植入。
[Abstract]:Objective:. The study of ECAP in the NRT examination of auditory brainstem response (ABR) with partial abnormality of DPOAE in cochlear implants was conducted to investigate whether the characteristics of hearing mechanics were the diagnostic basis for cochlear cochlear deafness with retrocochlear deafness. MAIS was used to evaluate the effect of cochlear implants in these patients. Methods:. A retrospective case-control study was conducted to select 18 patients with partial abnormal DPOAE and 18 patients with complete abnormality of DPOAE in the cochlear implants from 2002 to 2010. The ECAP threshold and MAIS score were compared between the two groups. Results:. 1. There were 3, 4 and 5 frequencies of DPOAE in study group A, and the frequencies were mainly in the middle and high frequency regions. 2. The number of ECAP in group A was higher than that in group B during operation, and the difference was statistically significant (P 0.05). The total number of ECAP was higher in group A than in group B, and in group A, the number of ECAP was higher than that in group B during operation, boot up, rediagnosis and three times examination. The difference was statistically significant (P 0.05). The rate of total ECAP in group A was higher than that in group B according to the composition of straight bend electrode. The difference was statistically significant. The detectable rate of ECAP in group A was significantly higher than that in group B at different times, in which the rate of ECAP during operation and operation was higher than that in group B. There were significant differences in P05 between operation and follow-up, but there was no significant difference between the two groups. The ECAP threshold of each electrode was significantly higher than that of group B (P 0.05), and that of electrode 22 was significantly higher than that of group B (P 0.05), and that of electrode 22 was significantly higher than that of group B (P < 0.05). 3Compared with the score of Mais in group A and B, the scores of 3-10 questions in group A were higher than those before operation, and the difference was statistically significant (P 0.05). There was no significant difference between group A and group B (P 0.05). 4 there was no significant difference in age between A 1 and B 1 A 2 and B 2 A and B (P 0.05). Conclusion:. There were pathological changes in the outer hair cells of cochlea in some patients with abnormal DPOAE. But there are still some functional outer hair cells in cochlear region corresponding to middle and high frequency. Cochlear and retrocochlear lesion cochlear cochlear and retrocochlear lesion cochlear cochlear cochlear and retrocochlear lesion cochlear deafness may exist in the cochlea cochlear and cochlear lesion cochlear cochlear cochlear deaf@@. Reaction is one of the diagnostic bases for this group of patients. The retrocochlear lesions of patients with partially abnormal DPOAE and no wave response of ABR in this study are co-existing in spiral ganglion cells or acoustic nerves or both. In this study, some abnormalities of DPOAE are found. Moreover, ABR without wave response could not be regarded as contraindication of cochlear implantation. Cochlear implants in these patients have a good effect and are suitable for cochlear implants.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R764.29

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