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目的:通过对儿童患者术后神经反应遥测(NRT)阈值的分析,总结其变化规律,为儿童人工耳蜗植入术后调试提供帮助。方法:测试40例接受Nucleus CI24R型多导人工耳蜗单侧植入术的患儿。测试使用澳大利亚Cochlear公司提供的便携式调试系统及NRT3.1版本软件。采用削减算法提取NRT反应波形,分别测试每位患者的第1、5、10、15、20号电极,NRT阈值使用NRT软件计算。分别在开机时、开机3、6和12个月时进行测试。结果:在术后同一测试时间,位于耳蜗不同部位电极的NRT阈值存在差异。耳蜗底部和顶部电极的NRT阈值较低,而位于耳蜗中部的电极NRT阈值较高。经单因素方差分析,不同部位NRT阈值均差异有统计学意义。同一测试电极,随术后开机时间的增长,NRT阈值呈逐渐增加的趋势。经单因素方差分析,术后不同测试时间NRT阈值均差异有统计学意义。结论:术后开机1年内,NRT阈值呈逐渐增加的趋势。若人工耳蜗植入术后调试需要NRT进行辅助,每次均应测试NRT阈值,以便更准确估算患者的行为反应T、C级,尤其对植入术后1年内的儿童患者更为重要。
OBJECTIVE: To summarize the changing rules of postoperative neurological reaction telemetry (NRT) threshold in pediatric patients and to provide assistance in the post-operative cochlear implant post-operative programming. Methods: Forty children undergoing unilateral implantation of Nucleus CI24R multi-cochlear cochlear implant were tested. Test using a portable debugging system provided by the Australian Cochlear company and NRT3.1 version of the software. NRT response waveforms were extracted using a subtraction algorithm and electrodes 1, 5, 10, 15 and 20 of each patient were tested separately. The NRT threshold was calculated using NRT software. At boot, boot 3, 6 and 12 months when the test. Results: At the same test time after surgery, there were differences in NRT threshold values between electrodes located in different parts of the cochlea. The NRT threshold was lower for the bottom and top electrodes of the cochlea, while the NRT threshold was higher for the electrode located in the middle of the cochlea. After single factor analysis of variance, NRT thresholds in different sites were significantly different. The same test electrode, with the boot time after the increase, NRT threshold showed a gradual increase trend. After single-factor analysis of variance, postoperative NRT threshold values at different test times were statistically significant differences. Conclusions: Within one year after starting up, the threshold of NRT gradually increases. If cochlear implantation requires postoperative NRT supplementation, NRT thresholds should be tested each time to provide a more accurate estimate of the patient’s response to T and C levels, especially for pediatric patients within 1 year after implantation.