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人工耳蜗植入患者的术后并发症及护理干预的影响

Postoperative complications in patients with cochlear implants and impacts of nursing intervention.

作者信息

Hou Jun-Hua, Zhao Shu-Ping, Ning Fei, Rao Shao-Qi, Han Dong-Yi

机构信息

Department of Otorhinolaryngology/Head and Neck Surgery, Chinese People's Liberation Army General Hospital, Beijing, China.

出版信息

Acta Otolaryngol. 2010 Jun;130(6):687-95. doi: 10.3109/00016480903334445.

Abstract

CONCLUSION

This study shows that cochlear implantation is relatively safe surgery with few major complications and within acceptable limits. However, close follow-up observation and effective medical and nursing intervention could alleviate further complications and thus become key elements for promoting recovery of patients undergoing such surgery.

OBJECTIVES

Cochlear implantation has become an effective method for curing patients disabled by profound hearing loss in China. However, full exploration of the associated complications remains to be completed. The objective of this study was thus to analyse the postoperative complications in patients with cochlear implants (CIs) in order to design improved measures for clinical and nursing interventions.

METHODS

A retrospective study of 262 patients receiving CIs at the Department of Otorhinolaryngology/Head and Neck Surgery, Chinese People's Liberation Army General Hospital, Beijing, China from March 1997 to December 2006 was conducted.

RESULTS

Among 262 patients, 4 cases (1.5%) had 1 or more major complications requiring substantial medical or nursing interventions, including 1 case of cerebrospinal fluid (CSF) otorrhoea accompanied by meningitis, 2 cases of facial nerve paresis and 1 case of perforation of tympanic membrane. Forty cases (15.3%) had some form of minor complication that settled spontaneously or easily with conventional treatments and nursing, of which dizziness and vomiting was the most frequent (4.2%), followed by CSF gusher without otorrhoea and/or induced meningitis (2.7%), tinnitus (1.9%) and facial nerve partially exposed without paralysis (1.5%). Eleven cases (4.2%) had some symptoms associated with installation of the cochlear device. Except for one patient who had no response after implantation because his auditory nerves were underdeveloped, all the patients who received appropriate treatment and nursing intervention had a favourable prognosis.

摘要

结论

本研究表明,人工耳蜗植入术是一种相对安全的手术,主要并发症较少,且在可接受范围内。然而,密切的随访观察以及有效的医疗和护理干预能够减轻进一步的并发症,因此成为促进此类手术患者康复的关键因素。

目的

人工耳蜗植入术已成为中国治疗重度听力丧失致聋患者的有效方法。然而,对相关并发症的全面探索仍有待完成。因此,本研究的目的是分析人工耳蜗植入患者的术后并发症,以便设计改进的临床和护理干预措施。

方法

对1997年3月至2006年12月在中国人民解放军总医院耳鼻咽喉头颈外科接受人工耳蜗植入的262例患者进行回顾性研究。

结果

在262例患者中,4例(1.5%)出现1种或多种需要大量医疗或护理干预的主要并发症,包括1例脑脊液耳漏伴脑膜炎、2例面神经麻痹和1例鼓膜穿孔。40例(15.3%)出现某种形式的轻微并发症,这些并发症可自行缓解或通过常规治疗和护理轻松解决,其中头晕和呕吐最为常见(4.2%),其次是无耳漏和/或诱发脑膜炎的脑脊液喷射(2.7%)、耳鸣(1.9%)以及面神经部分暴露但无麻痹(1.5%)。11例(4.2%)出现与人工耳蜗装置安装相关的一些症状。除1例因听神经发育不全植入后无反应外,所有接受适当治疗和护理干预的患者预后良好。

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