發(fā)布時間：2018-04-19 11:18

  本文選題：糖皮質(zhì)激素 + 人工耳蝸植入　； 參考：《中華耳科學雜志》2015年04期

【摘要】：目的探討糖皮質(zhì)激素不同使用方法對兒童人工耳蝸植入者術(shù)后早期電極阻抗的影響。方法回顧性收集于我院行澳大利亞Nucleus 24CA型多導人工耳蝸植入兒童患者資料,根據(jù)糖皮質(zhì)激素使用方法納入經(jīng)鼓室圓窗給藥組(A組)及經(jīng)鼓室圓窗聯(lián)合全身靜脈給藥組(B組);以各組22個電極相對于耳蝸內(nèi)位置分為高頻段(3-6)、中頻段(10-13)及低頻段(17-20)3個亞組,檢測各組術(shù)中、開機(術(shù)后1月)、術(shù)后3月及術(shù)后6月電極阻抗值,并進行統(tǒng)計學分析。結(jié)果兩組22個電極阻抗平均值均在術(shù)中較低,開機時最高,術(shù)后6個月達最低值;開機、術(shù)后3月及術(shù)后6月兩組電極阻抗值比較差異有統(tǒng)計學意義(P0.05);在各亞組間比較中,兩組在術(shù)中不同頻段比較無統(tǒng)計學差異(P0.05),開機時兩組間各頻段電阻抗值比較差異有統(tǒng)計學意義(P0.05),B組各頻段電極阻抗值小于A組,且兩組開機與術(shù)中電阻抗差值均在高頻段較大;術(shù)后3月及6月兩組高頻段比較仍具統(tǒng)計學差異(P0.05),而低頻段無明顯差別(P0.05)。結(jié)論經(jīng)鼓室圓窗聯(lián)合全身靜脈給藥途徑在降低術(shù)后電極阻抗效果方面優(yōu)于局部單獨使用,在高頻段尤為明顯,提示糖皮質(zhì)激素聯(lián)合應(yīng)用更有利于降低耳蝸植入后電極周圍纖維化組織形成。
[Abstract]:Objective to investigate the effect of different use of glucocorticoid on early electrode impedance after cochlear implantation in children.Methods the data of children with Nucleus 24CA multichannel cochlear implant in Australia were retrospectively collected.According to the method of glucocorticoid use, the two groups were divided into three subgroups: group A (treated by transtympanic window) and group B (treated by trantympanic window combined with systemic intravenous administration), and divided into three subgroups according to the position of 22 electrodes in each group relative to the cochlea: high frequency band 3-6, middle frequency band 10-13) and low frequency band 17-20).The impedance of electrode was measured during operation (1 month after operation, 3 months after operation and 6 months after operation) and analyzed statistically.Results the average impedance of 22 electrodes in the two groups was lower during operation, the highest at boot time, and the lowest at 6 months after operation, and the difference between the two groups was statistically significant at 3 months after operation and 6 months after operation (P 0.05).There was no statistical difference between the two groups in different frequency bands during operation (P 0.05). There was significant difference between the two groups in the electrical impedance values of each frequency band. The impedance of each frequency band in group B was lower than that in group A, and the difference between the two groups was larger in the high frequency range.Three months and six months after operation, there was still a significant difference in high frequency bands between the two groups, but there was no significant difference in low frequency bands between the two groups (P 0.05).Conclusion Transtympanic window combined with systemic intravenous administration is superior to local use alone in reducing electrode impedance after operation, especially in high frequency range.The results suggest that the combination of glucocorticoid and glucocorticoid can reduce the formation of fibrotic tissue around the electrode after cochlear implantation.
【作者單位】： 廣東省人民醫(yī)院廣東省醫(yī)學科學院耳鼻咽喉頭頸外科;
【基金】：廣東省科技計劃項目(2012B031800408)
【分類號】：R764.93

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