Article record

儿童人工耳蜗植入后的不使用率：系统综述与荟萃分析。

Non-usage rates after paediatric cochlear implantation: A systematic review and meta-analysis.

综述 Meta耳科IF 1.7Q2

文献信息

PMID	42828822
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Joy Xin Yi Au 查看其他 8 位作者 Benjamin Kye Jyn Tan；Swarnadeep Mandal；Juanita Jaslin James；Li Xuan Choo；Esther Yanxin Gao；Yao Hao Teo；Xueying Goh；Woei Shyang Loh
作者单位	Department of Otorhinolaryngology, National University Hospital, Singapore. Electronic address: auxyjoy@gmail.com. 查看其他 5 条单位信息 Department of Otorhinolaryngology, Singapore General Hospital, Singapore.；Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.；Yong Loo Lin School of Medicine, National University of Singapore, Singapore.；Department of Otorhinolaryngology, National University Hospital, Singapore.；Department of Otorhinolaryngology, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
期刊	International journal of pediatric otorhinolaryngology
SCI 分区	Q2
IF	1.7
研究类型	综述 Meta · 临床
所属专科	耳科

中文摘要

目的： 确定儿童人工耳蜗（CI）接受者中长期不使用和部分使用的患病率，并识别与依从性欠佳相关的因素。
数据来源： 对包括PubMed、Embase和Cochrane Library在内的主要电子数据库进行了系统检索，以识别报告儿童人群CI使用模式的研究。
综述方法： 我们按照PRISMA指南对29项研究（n = 2595）进行了系统综述和荟萃分析。使用随机效应模型和广义线性混合模型计算合并患病率估计值。
结果： 不使用的合并患病率为4.45%（95% CI：2.21-8.78，p < 0.0001），部分使用（<8小时/天）为8.99%（95% CI：5.91-13.44，p < 0.0001）。不使用率在大洋洲最高，为27.27%（95% CI = 9.05-58.57），在欧洲最低，为1.99%（95% CI：1.00-3.94）。与正常人群相比，特定临床亚组中的不使用率也显著更高（16.29% vs 2.29%）。听力损失持续时间较长与部分使用患病率较高相关（系数0.477，p < 0.001）。与12-24个月相比，早期植入（≤12个月）与部分使用减少相关（6.89% vs 16.81%）。未发现与随访持续时间、性别或植入侧别存在显著关联。
结论： 超过十分之一的接受者表现出长期依从性欠佳，并因地区、临床亚组、听力损失持续时间和植入年龄而异。需要有针对性的、风险分层的策略来改善依从性和长期结局。

英文摘要

OBJECTIVE: To determine the prevalence of long-term cochlear implant (CI) non-use and partial use in paediatric recipients and identify factors associated with suboptimal adherence.
DATA SOURCES: A systematic search of major electronic databases including PubMed, Embase, and the Cochrane Library was performed to identify studies reporting CI usage patterns in paediatric populations.
REVIEW METHODS: We conducted a systematic review and meta-analysis of 29 studies (n = 2595) following PRISMA guidelines. Pooled prevalence estimates were calculated using random-effects models with generalized linear mixed model.
RESULTS: The pooled prevalence of non-use was 4.45% (95% CI: 2.21-8.78, p < 0.0001) and partial use (<8 h/day) was 8.99% (95% CI: 5.91-13.44, p < 0.0001). Non-use was highest in Oceania at 27.27% (95% CI = 9.05-58.57), and lowest in Europe at 1.99% (95% CI: 1.00-3.94). Compared to normal population, non-use rates are also significantly higher among specific clinical subgroups (16.29% vs 2.29%). Longer duration of hearing loss was associated with a higher prevalence of partial-use (coefficient 0.477, p < 0.001). Compared to 12-24 months, early implantation (=<12 months) was associated with reduced partial use (6.89% vs 16.81%). No significant associations were found with follow up duration, sex or implant laterality.
CONCLUSION: More than one-tenth of recipients demonstrated suboptimal long-term adherence, varying by region, clinical subgroups, hearing loss duration, and implantation age. Targeted, risk-stratified strategies are needed to improve adherence and long-term outcomes.