CAJ | 학술논문

目的回顾语后聋病人在人工耳蜗植入术后一年内的程序图参数设置,研究其中主要参数T值和C值的变化规律,更好地为语后聋病人制定复诊计划.方法收集我科近年来接受植入手术的语后聋病人共16例(17耳),康复时间均达一年以上,选取他们程序图中高频区1号电极、中频区11号电极以及低频区22号电极为研究对象,选择分别代表着开机、首次程序调整、程序完善和长期随访的术后第1个月、第2个月、术后半年左右以及术后1年四个典型时间段,记录四次复诊时各电极T值、C值,使用单因方差分析检验,对每次复诊时T值的变化以及C值的变化情况进行统计学分析.结果各电极的T值自术后第1月复诊时既保持相对稳定值,四次复诊的T值在相互间两两比较中均无明显统计学差异(p>0.05),而在每次复诊时同一电极C值的比较中,首次复诊分别与后三次复诊的C值在两两比较中均具有显著统计学差异(p<0.05),后三次复诊之间的C值比较则无统计学意义(p>0.05),且术后第1个月时的C值明显低于后三次.结论术后第1个月和第2个月时的复诊在整个康复周期中意义重大,第1个月复诊目的主要在于获得准确的T值,使病人重新感受到声音,而第2个月复诊即可测得准确地C值,从而制定出病人主观感觉适合且相当稳定程序图,为后续的听觉言语康复打下基础,程序图的调试应按照循序渐进的原则,根据每个时期病人的特点制定每次复诊计划.
목적회고어후롱병인재인공이와식입술후일년내적정서도삼수설치,연구기중주요삼수T치화C치적변화규률,경호지위어후롱병인제정복진계화.방법수집아과근년래접수식입수술적어후롱병인공16례(17이),강복시간균체일년이상,선취타문정서도중고빈구1호전겁、중빈구11호전겁이급저빈구22호전겁위연구대상,선택분별대표착개궤、수차정서조정、정서완선화장기수방적술후제1개월、제2개월、술후반년좌우이급술후1년사개전형시간단,기록사차복진시각전겁T치、C치,사용단인방차분석검험,대매차복진시T치적변화이급C치적변화정황진행통계학분석.결과각전겁적T치자술후제1월복진시기보지상대은정치,사차복진적T치재상호간량량비교중균무명현통계학차이(p>0.05),이재매차복진시동일전겁C치적비교중,수차복진분별여후삼차복진적C치재량량비교중균구유현저통계학차이(p<0.05),후삼차복진지간적C치비교칙무통계학의의(p>0.05),차술후제1개월시적C치명현저우후삼차.결론술후제1개월화제2개월시적복진재정개강복주기중의의중대,제1개월복진목적주요재우획득준학적T치,사병인중신감수도성음,이제2개월복진즉가측득준학지C치,종이제정출병인주관감각괄합차상당은정정서도,위후속적은각언어강복타하기출,정서도적조시응안조순서점진적원칙,근거매개시기병인적특점제정매차복진계화.
Objective This retrospective study examined the setup process of mapping parameters within one year af?ter artificial cochlear implantation in patents with post-lingual deafness. T-lever and C-lever were selected as the main pa?rameters to determine the pattern of adjustment. It aimed to improve adjustment planning for these patients during their fol?low up visits. Methods Sixteen patients (17 ears) with post-lingual deafness who underwent implant surgeries were recruit?ed from patients treated in the authors’practice. All participants were followed up for at least one-year recovery period. Electrodes No. 1, 11 and 22 were tested, which corresponded to the high, middle and low frequency fields among mapping. T and C values at each electrode were recorded for data analysis at the first, second, sixth and 12th months, representing the four typical time points of switch-on, first mapping adjustment, mapping perfection and long term follow-up, respectively. Results T values kept relatively stable during the first month after operation and showed no significant difference on pair?wise comparisons at all four follow up visits (p>0.05). C values at the first follow up visit were noticeably lower than those at the other three follow up times, (p<0.05), but not different among those of the latter three times (p>0.05). Conclusion The follow up visits at the first and second months play a key role during the rehabilitation course. The visit at the first month provides accurate T values, allowing regain of sound sensation, whereas the visit at the second month provides accurate C values, which allows establishment of subjectively comfortable sound sensation and a stable mapping program as the founda?tion of future audition and speech rehabilitation. Mapping adjustment should be progressive and the visit plan should be made based upon the condition of each individual patient at the particular visit.