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

【摘要】：目的: 通過對聽力學(xué)檢查表現(xiàn)為DPOAE部分異常而聽性腦干反應(yīng)ABR無波反應(yīng)的患者行人工耳蝸術(shù)后NRT檢測中ECAP的研究來探討此類聽力學(xué)特征是否為耳蝸伴有蝸后性聾的診斷依據(jù),用MAIS評價(jià)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(biāo)準(zhǔn)的DPOAE部分異�；颊�18例和DPOAE完全異�；颊�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(jié)果: 1、研究組A中患者的DPOAE有3個(gè)、4個(gè)及5個(gè)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(shù)中2號電極A組高于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)�？偟腅CAP未引出數(shù)比較,術(shù)中、開機(jī)、復(fù)診及三次檢測A組均高于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。按直彎電極構(gòu)成校正三次總ECAP未引出率,A組大于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。A、B兩組組內(nèi)不同時(shí)間ECAP檢出率比較,其中術(shù)中與開機(jī)、術(shù)中與復(fù)診所得P0.05差異均有統(tǒng)計(jì)學(xué)意義,但開機(jī)與復(fù)診P0.05差異均無統(tǒng)計(jì)學(xué)意義。各電極ECAP閾值比較,術(shù)中22號電極、復(fù)診2、6、18、22號電極A組大于B組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 3、MAIS得分比較,A、B兩組3-10題得分術(shù)后均高于術(shù)前,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。A、B兩組術(shù)后得分比較,差異無統(tǒng)計(jì)學(xué)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(jì)學(xué)意義P0.05。 結(jié)論: DPOAE部分異�；颊叨佂饷�(xì)胞有病變,但在中高頻對應(yīng)的耳蝸區(qū)域仍殘存部分有功能的外毛細(xì)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(yīng)是這一類患者的診斷依據(jù)之一。本研究中DPOAE部分異常且ABR無波反應(yīng)的患者其蝸后病變部位在螺旋神經(jīng)節(jié)細(xì)胞或聽神經(jīng)或兩者病變共存。本研究中DPOAE部分異常且ABR無波反應(yīng)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(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R764.29

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉愛國,崔永華,葛新,王春芳;耳蝸性聾的畸變產(chǎn)物耳聲發(fā)射測試[J];臨床耳鼻咽喉科雜志;2003年10期

2 巴重惠,王曉力;小兒聽神經(jīng)病的早期干預(yù)[J];中國聽力語言康復(fù)科學(xué)雜志;2003年01期

3 王海濤,周楓,章少彬;畸變產(chǎn)物耳聲發(fā)射與純音聽閾間測試頻率的相關(guān)性研究[J];中國聽力語言康復(fù)科學(xué)雜志;2005年04期

4 王錦玲;石力;薛飛;孫偉;高磊;謝娟;韓麗萍;;聽神經(jīng)病聽力學(xué)特征及病損部位分析[J];聽力學(xué)及言語疾病雜志;2007年02期

5 陳雪清;韓德民;趙嘯天;孔穎;劉莎;莫玲燕;劉博;鄭軍;李永新;王碩;吳燕君;;人工耳蝸植入術(shù)后電極阻抗特性分析[J];聽力學(xué)及言語疾病雜志;2007年05期

6 羅仁忠;溫瑞金;黃振云;周佳霖;陳倩;鐘建文;;小兒蝸后聽覺神經(jīng)損害并耳蝸受損的聽力學(xué)特征分析[J];聽力學(xué)及言語疾病雜志;2008年01期

7 冀飛;郗昕;洪夢迪;陳艾婷;劉軍;韓東一;;直電極與彎電極人工耳蝸植入患者神經(jīng)興奮分布空間的比較[J];聽力學(xué)及言語疾病雜志;2008年04期

8 李珍;王愷;胥科;陶勇;康躍科;孟照莉;鄭蕓;;ABR最大聲輸出無反應(yīng)兒童的行為測聽結(jié)果分析[J];聽力學(xué)及言語疾病雜志;2010年02期

9 葉海波;時(shí)海波;于棟禎;陳正儂;殷善開;;高膽紅素血癥對新生豚鼠畸變產(chǎn)物耳聲發(fā)射的影響[J];聽力學(xué)及言語疾病雜志;2010年04期

10 楊新明,盧永德,謝鼎華;聽性腦干反應(yīng)在診斷腦干放射性損害中的意義[J];中國耳鼻咽喉顱底外科雜志;1999年04期

，

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