捐赠项目人工耳蜗植入的临床流程研究  

Research on the clinical work flow of cochlear implant donation project

作　　者：张道行[1] 张岩昆[1] 田昊[1] 王伟伟[1] 

机构地区：[1]首都医科大学附属北京友谊医院耳鼻咽喉科,北京100050

出　　处：《中国听力语言康复科学杂志》2008年第1期73-76,共4页Chinese Scientific Journal of Hearing and Speech Rehabilitation

摘　　要：目的总结本院2007年捐赠人工耳蜗植入的复筛流程和标准、入院手术流程、手术结果以及开机效果,为今后承担集中人工耳蜗植入手术工作提供经验。方法2007年4～9月,对79例患者集中进行复筛、手术和术后开机。结果79例初筛患者复筛后确定手术77例,初、复筛吻合率为97.46%。手术流程平均47分钟/例,麻醉流程平均80分钟/例。77例术中检测:①阻抗,CG10.3591±4.145、MP111.5539±4.086、MP212.6861±3.983、MP1+211.8248±4.004,均在正常值范围;②NRT,引出74例、未引出3例,引出率为96.1%。77例术后CR电极平片:全部电极呈1～1.25圈旋转。77例患者术后平均36天开机,开机后的编程:T值平均121±11.923CL、C值143±15.487CL,开机后有明确主观反应的72例、主观反应不明确的5例,对这5例进行EABR检测,检出5例,检出率100%。77例术后并发症0例,手术成功率100%,术后有效率100%。结论捐赠人工耳蜗植入可以集中手术,术前制定一套科学、完善的复筛、手术流程,按流程进行复筛、手术,可以提高手术效率、手术质量和手术安全性,降低或消灭并发症的发生。Objective To summarize 2007 cochlear implant donation project in our hospital including secondary screening procedure and criterion, operative procedure and post-operative results, and introduce our experience of cochlear implant operation. Methods From April to September 2007, we standardized the cochlear implant donation project on secondary screening procedure, operative procedure and postoperative switch-on. Results In 79 children who passed preliminary screening, 77 passed secondary screening with 97.46% coincidence. The average operation time was 48 minutes and the average anesthesia time was 80 minutes. Monitoring during operation： （D average impedance, CG 10.3591± 4.145, MP1 11.5539 ± 4.086, MP212.6861 ± 3.983, MP1＋2 11.8248 ± 4.004, all within normal range：（2） NRT, 74 out of 77 children were detected with typical waveforms, positive rate 96.1%. Post-operative X-ray： the electrodes made 1-1.25 circles in the cochlea. Average switch-on time was 34 days after operation. Average T-levels were 121 ±11.923 CL, C-levels were 143 ± 15.487 CL. Seventy-two children had definite subjective reaction after mapping. EABR examination was performed in 5 children with indefinite subjective reaction. All these 5 children had typical EABR waveforms. No complications happened in all 77 cases, effective rate was 100%. Conclusion In cochlear implant donation project, we shall perform secondary screening and operation according to predesigned procedures so as to enhance the efficiency, quality and security of cochlear implant operation and to reduce the complications.

关 键 词：捐赠项目 人工耳蜗植入 初筛 复筛 

分 类 号：R764[医药卫生—耳鼻咽喉科]