新冠疫情对人工耳蜗植入流程及疗效影响的研究  

Impacts of COVID-19 on Experiences and Treatment Outcomes in Cochlear Implantation Patients

作　　者：刘昭颖 唐菲 徐欣[1] 曹伟 杨崇灵 王敏华 马清云 刘军[1,2] LIU Zhaoying;TANG Fei;XU Xin;CAO Wei;YANG Chongling;WANG Minhua;MA Qingyun;LIU Jun(Department of Otolaryngology-Head&Neck Surgery,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;Department of Otolaryngology-Head&Neck Surgery,the Sixth Medical Center of PLA General Hospital,State Key Lab of Auditory and Vestibular Science,National Clinical Research Center for Otolaryngologic Diseases,State Key Lab of Hearing Science,Ministry of Education,Beijing Key Lab of Hearing Impairment Prevention and Treatment,Beijing 100048,China;Department of Otolaryngology-Head&Neck Surgery,Affiliated Hospital of North Sichuan Medical College,Sichuan 637000,China)

机构地区：[1]解放军总医院第七医学中心耳鼻咽喉-头颈外科,北京100700 [2]解放军总医院第六医学中心耳鼻咽喉-头颈外科医学部、听觉与平衡觉国家重点实验室、国家耳鼻咽喉疾病临床医学研究中心、聋病教育部重点实验室、聋病防治北京市重点实验室,北京100048 [3]川北医学院、川北医学院附属医院耳鼻咽喉-头颈外科,四川637000

出　　处：《中华耳科学杂志》2023年第5期648-654,共7页Chinese Journal of Otology

基　　金：北京市科技计划首都市民健康项目培育基金(Z131100004013019);解放军总医院临床科研扶持基金课题(2012FC-TSYS-4017);解放军总医院科技创新基金项目(06ZY13)。

摘　　要：目的探讨新冠疫情对人工耳蜗植入(cochlear implantation,CI)就医流程的影响以及采取针对性措施后患者就医满意度和疗效的变化。方法收集疫情期间行CI手术的55例患者的临床资料,按是否给予干预分为两组:A组33例,完成《新冠肺炎疫情对CI患者就医影响调查问卷》,分析疫情对CI患者就医的影响及影响因素;B组22例,完成《CI患者对疫情影响因素相对应措施满意度调查问卷》,分析CI患者对疫情影响因素相对应措施的满意度;两组均完成《住院患者就医满意度调查问卷》及听觉行为分级(categories of auditory performance,CAP)量表和言语可懂度分级(speech intelligibility rating,SIR)量表,比较两组就医满意度及康复效果。结果住院封闭式管理(75.76%)、封控限制出行(66.67%)、言语刺激机会减少(63.64%)是疫情影响CI患者就医的主要因素;患者及家属对家属全程陪护(4.82±0.40)、详细介绍治疗方案(4.73±0.55)、开设检查/手术绿色通道(4.59±0.80)等措施的满意度较高;两组就医满意度分别为78.78%和100.00%,差异有统计学意义(P=0.034);两组CAP评分分别为4.5±2.2和4.3±2.1,差异无统计学意义(P=0.645);两组SIR评分分别为3.9±1.0和3.6±1.3,差异无统计学意义(P=0.224)。结论疫情对CI就医流程各环节均有影响;采取针对性干预措施后CI患者就医满意度提高,但对听觉言语康复的短期效果无明显影响。Objective To assess impacts on experiences of cochlear implantation(CI)patients by COVID-19 and effects of targeted mitigation strategies.Methods Of 55 patients receiving CI during the COVID-19 pandemic,some went through standard care(Group A,n=33),while measures to mitigate COVID impacts were adopted for the rest patients(Group B,n=22).Patients in Group A completed a questionnaire regarding their experiences specifically with CI related care to identify COVID-19 related influencing factors,and those in Group B completed a different questionnaire on their satisfaction toward strategies adopted to mitigate COVID-19 related constraints.Patients to both groups completed a questionnaire on the overall experience with their care.The answers to the questionnaires were compared between the two groups along with their CAP and SIR scale scores.Results Closed inpatient management policy(75.76%),travel restriction(66.67%),and limited speech training(63.64%)were the main factors affecting CI related care.Family members'presence(4.82±0.40),detailed explanation of treatment plans(4.73±0.55)and fast tracks for examination/surgery(4.59±0.80)were the most important factors contributing to satisfaction which was rating 78.78%in Group A and 100.00%in Group B(P=0.034).At 6 months after surgery,CAP scores of Groups A and B were 4.5±2.2 and 4.3±2.1,respectively(P=0.645),and SIR scores of Groups A and B were 3.9±1.0 and 3.6±1.3,respectively(P=0.224).Conclusion The COVID-19 pandemic affected all aspects of CI related care.Targeted mitigating strategies improved patient satisfaction,albeit with no significant effect on short-term auditory speech rehabilitation outcomes.

关 键 词：新冠肺炎疫情 人工耳蜗植入 影响 对策 

分 类 号：R764[医药卫生—耳鼻咽喉科]