糖皮质激素对儿童人工耳蜗植入后早期电极阻抗的影响

发布时间：2018-04-19 11:18

本文选题：糖皮质激素 + 人工耳蜗植入　；参考：《中华耳科学杂志》2015年04期

【摘要】：目的探讨糖皮质激素不同使用方法对儿童人工耳蜗植入者术后早期电极阻抗的影响。方法回顾性收集于我院行澳大利亚Nucleus 24CA型多导人工耳蜗植入儿童患者资料,根据糖皮质激素使用方法纳入经鼓室圆窗给药组(A组)及经鼓室圆窗联合全身静脉给药组(B组);以各组22个电极相对于耳蜗内位置分为高频段(3-6)、中频段(10-13)及低频段(17-20)3个亚组,检测各组术中、开机(术后1月)、术后3月及术后6月电极阻抗值,并进行统计学分析。结果两组22个电极阻抗平均值均在术中较低,开机时最高,术后6个月达最低值;开机、术后3月及术后6月两组电极阻抗值比较差异有统计学意义(P0.05);在各亚组间比较中,两组在术中不同频段比较无统计学差异(P0.05),开机时两组间各频段电阻抗值比较差异有统计学意义(P0.05),B组各频段电极阻抗值小于A组,且两组开机与术中电阻抗差值均在高频段较大;术后3月及6月两组高频段比较仍具统计学差异(P0.05),而低频段无明显差别(P0.05)。结论经鼓室圆窗联合全身静脉给药途径在降低术后电极阻抗效果方面优于局部单独使用,在高频段尤为明显,提示糖皮质激素联合应用更有利于降低耳蜗植入后电极周围纤维化组织形成。
[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.
【作者单位】：广东省人民医院广东省医学科学院耳鼻咽喉头颈外科;
【基金】：广东省科技计划项目(2012B031800408)
【分类号】：R764.93

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