{
  "abstract": "随着人口老龄化进程的加快，老年性听力损失患病率持续上升，部分患者进展为重度至极重度听力障碍，成为人工耳蜗植入的候选人群。相较于儿童及中青年患者，老年患者在病因构成、全身功能储备、合并基础疾病、听觉剥夺时长及术后康复依从性等方面具有特殊性，使其在术前决策及围手术期管理中面临更多挑战。本文结合临床实践与相关研究，围绕老年听障患者人工耳蜗植入过程中的关键临床问题进行系统梳理，内容包括耳聋病因与危害、植入动机、期望管理、经济负担、前庭功能评估、不同听力损失类型下的植入策略、麻醉方式选择及植入体区皮瓣处理等。笔者强调，老年患者术前评估不应仅以年龄作为判断依据，应关注听障持续时间，尤其是重度至极重度听力损失持续时间对术后言语识别和听觉适应的影响。随着人工耳蜗适应证的拓展，单侧听障和非对称性听力损失患者的适应证、术后双耳听觉适应及康复依从性亦需重视；对于双侧重度至极重度感音神经性听力障碍患者应充分评估单侧植入后可能存在的听觉疲劳及双侧植入在声源定位、噪声下言语识别和降低聆听负荷方面的潜在优势。总体而言，老年人工耳蜗植入应基于个体化评估，综合权衡听觉获益、手术风险、前庭功能、经济条件及康复支持，制订合理的方案。加强术前沟通、优化期望管理及规范围手术期处理，有助于提高患者的依从性和长期获益。本文旨在为老年人工耳蜗植入的临床决策及全流程管理提供参考。",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "林以鹏"
    },
    {
      "name": "高珊仙"
    },
    {
      "name": "张丽娜"
    },
    {
      "name": "刘天翊"
    },
    {
      "name": "梁爽"
    },
    {
      "name": "梁巍"
    },
    {
      "name": "银力"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ccymte8ctgacq.bib",
  "cited_by": 0,
  "doi": null,
  "fulltext_url": "http://www.chsr.cn/zh/article/doi/10.3969/j.issn.1672-4933.2026.04.022/",
  "id": "ccymte8ctgacq",
  "issns": [
    "1672-4933"
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  "landing_url": "http://www.chsr.cn/zh/article/doi/10.3969/j.issn.1672-4933.2026.04.022/",
  "language": "zh",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-07-01",
  "publisher": "Limited Liability Company of Chinese Scientific Journal of Hearing and Speech Rehabilitation",
  "ris": "https://research.draconitic.com/paper/ccymte8ctgacq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:18Z",
      "native_id": "315dafaae80b46acaa52c2806eecf44f",
      "source": "doaj",
      "url": "http://www.chsr.cn/zh/article/doi/10.3969/j.issn.1672-4933.2026.04.022/"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:R",
      "subfield": "general"
    }
  ],
  "title": "老年听障患者人工耳蜗植入临床问题探讨（Ⅰ）——术前决策与围手术期关键问题",
  "title_text": "老年听障患者人工耳蜗植入临床问题探讨（Ⅰ）——术前决策与围手术期关键问题",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:18Z",
  "url": "https://research.draconitic.com/paper/ccymte8ctgacq",
  "venue": "Zhongguo tingli yuyan kangfu kexue zazhi",
  "versions": []
}