不同年龄语前聋患者人工耳蜗植入效果的Meta分析

许庆庆; 翟所强; 韩东一; 杨仕明; 申卫东

doi:10.13201/j.issn.1001-1781.2015.04.005

不同年龄语前聋患者人工耳蜗植入效果的Meta分析

- 中国人民解放军总医院耳鼻喉头颈外科(北京, 100853)
基金项目:
973(No:2014CB541706)

973(No:2012CB967900)

国家自然科学基金(No:81271081)

详细信息

通讯作者: 翟所强,E-mail:zhaisq@301hospital.com.cn

中图分类号: R764.5

收稿日期: 2014-09-05

Meta-analysis on effectiveness of prelingually deaf patients at different ages following cochlear implantation

- Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital of Beijing, 100853, China

More Information

Corresponding author: ZHAI Suoqiang, E-mail: zhaisq@301hospital.com.cn

Received Date: 05 September 2014

摘要

摘要: 目的: 通过评价不同年龄语前聋患者人工耳蜗植入后的听觉及言语能力,为语前聋人工耳蜗植入患者康复效果提供合理预期值,更好辅助临床工作。方法: 使用相关的关键词在PubMed、医知网、维普医学、万方数据、中国医院知识书仓、中国知网等电子数据库进行文献检索,限定语种为中文和英文。提取的数据包括:作者、出版时间、诊断等。治疗效果用言语识别率和听觉能力来衡量。Meta分析根据异质性大小采用固定效应模型或随机效应模型来分析。结果: 8篇文章被纳入研究,共包括442例患者。<3岁植入组(实验组)与3~6岁植入组(对照组)言语识别率比较,术后3个月及6个月实验组均低于对照组,差异有统计学意义;术后12个月2组言语识别率无差异或者对照组稍低,差异有统计学意义。2组听觉能力比较,术后3个月及6个月实验组低于对照组,差异有统计学意义(P<0.05);术后12个月实验组高于对照组。4.5岁前后植入组言语识别率比较显示,4.5岁之前组均高于4.5岁之后组,差异有统计学意义。12岁前后植入组言语识别率比较显示,3、6、12个月12岁之前组均高于12岁之后组,差异有统计学意义。18岁前后植入组(7~14岁植入为A组,>14~18岁植入为B组,18岁之后植入为C组)言语识别率比较显示,无论术后1年还是4年,均是A组>B组>C组,差异有统计学意义;听阈比较结果显示,术后1年A组结论: 语前聋患者3岁以前植入并坚持使用人工耳蜗进行科学、长时间的康复训练,可以实现康复效果的最优化。对大龄语前聋患者仍建议尽早行人工耳蜗植入,且植入时间越长,效果越好,植入时年龄越小,术后语言能力进步越快。进一步的具有更长随访期更大样本的多民族对照研究将会增加人工耳蜗疗效预期的可信度。
- 语前聋 /
- 年龄因素 /
- 耳蜗植入术 /
- Meta分析
Abstract: Objective: To assess the clinical effeetiveness of prelingually deaf children after cochlear implantation at different ages so as to provide reasonable expectations for the patients and guidance for the clinical treatment.Method: Electronic databases PubMed, YZ365.COM, WANFANG DATA, CMJD, CHKD, CNKI were searched using relevant keywords. Extracted data included author, year of publication, diagnosis, et al. Reported treatment outcomes were clustered into speech discrimination and hearing abilities. Meta-analyses were performed on studies with numerical results using random or fixed effects model.Result: There were eight randomized control studies including 442 patients. Comparing speech perception of prelingually deaf children after cochlear implantation younger than three years old (experimental group) and 3-6 years old (control group), three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed that experimental group performed significantly better than control group. Comparing hearing abilities, three and six months after operation showed that experimental group performed significantly worse than control group; 12 months after operation showed showed that experimental group performed significantly better than control group. Comparing speech perception of younger or older than 4.5 years old children showed that after 1.5-2 years of operation children implanted younger than 4.5 years of age performed significantly better than children implanted older than 4.5 years old. Comparing speech perception of 7-12 years old children showed that after 3, 6, 12 months of operation patients of 7-12 years old performed significantly better than those children older than 12 years old. Comparing speech perception of implantation younger or older than 18 years old (7-14 yeas old was group A, >14-18 yeas old was group B, older than 18 yeas old was group C) showed that after one and four years of operation A>B>C, and there were significant differences among them. Comparing warble tone threshold average (WTA) showed that after one year of operation AConclusion: Prelinguistically deafened patients younger than three years old with cochlear implantation, insisting on scienctific rehabilitation training for a long period of time can receive the optimal recovery effect. The older patients are suggested as early as possible receiving cochlear implantation. The longer they are implanted, the better results they will receive. Moreover, the younger age they are implanted, the faster postoperative language progress they will receive. Further controlled studies with longer follow-up periods and more person included may make the effectiveness of cochlear implantaion more reliable.
- prelingually deaf /
- age factors /
- cochlear implantation /
- Meta-analysis

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