语前聋人工耳蜗植入患者术后问卷调查分析

A questionnaires study on pre-lingual cochlear implantees

目的采用问卷调查的方式对人工耳蜗植入患者和家长进行术后的随访调查,以期了解术前检查、术后听力康复和言语训练情况,为人工耳蜗植入提供宝贵经验,为植入患者和家长提供康复指导和帮助。方法对56例重度和极重度语前聋植入人工耳蜗的患者家长进行问卷调查,调查主要包括患儿的术前评估、植入装置、植入年龄、手术后的言语康复训练、恢复时间、言语发展水平满意度和目前患儿存在的问题,以及为待植入人工耳蜗的家庭提供的建议等内容。结果调查显示①手术前的听力学和影像学检查较完善,但言语评估不足;②助听器配戴率(47/56),术前配戴助听器者植入人工耳蜗后的满意度与未配戴者无明显差异;③术后66.1%的患儿选择康复机构进行言语康复,9%在家庭训练;两种方式皆选者占16.1%;④75%的家庭对人工耳蜗有适当的期望值。75%认为植入效果与预期一致或更好;⑤53.6%的孩子于术后3-6个月内在听力言语方面表现出明显进步,一年和一年半后表现出明显进步的儿童分别占25%和5.4%,16.2%的植入者尚未表现出明显效果;⑥70%家长认为如不能通过助听器获得很好的听力补偿应尽早植入人工耳蜗。产品的选择、售后服务和持久的康复训练也是至关重要的。结论①家长及专业人员应重视术前的全面评估;②家长应充分了解人工耳蜗知识,有助于聋儿术后得到及时有效的康复语言训练;③调查显示植入时间越长,人工耳蜗植入患者的听觉发育效果越明显,故应重视听觉言语的长期培建。

Objective To know the pre-operative examinations and the headng rehabilitation after cochlear implantation by questionnaires, so as to provide valuable experiences for the relative works, to offer references and helps for implantee＇s families. Methods Fifty-six pre-lingual cochlear implantees＇ families were involved in this investigation. The investigation mainly included the examinations before operation, type of implant, age at surgery, the aural/oral post-operative rehabilitation, the present hearing and speech development, time of got well, the satisfying rate related to implantation, main problems and suggestions to the families ready for implantation etc. Results ①The assessments of audiology and image were relatively comprehensive, but deficient of speech evaluation. ②After implantation the satisfying rate with hearing aids had no obvious difference to those without acousticon. ③All the deaf children gained postoperative hearing and speech rehabilitation training in time. 66.1% were trained in the rehabilitation centers, while 9 % were teached in the families. 16.1% choosed the two ways of rehabilitation. ④75% families had appropriate expectations to cochlear implantation. 75% parents regarded the embedded effects were consistent with or even more better than anticipation. ⑤53.6% children had made obvious progress in hearing and speech aspect within 3 to 6 months, 25% in 12 months and 5.4% in 18 months. 16.2% implantees didn＇t put up obvious advancements yet. ⑥70% parents believed if hearing aids could not work well, the cochlear implantation was the best choice for the patients with severe and profound hearing loss. Operation should be done as soon as possible. The type of implant, the after service ,the postoperative hearing and speech rehabilitation are also very important. Conclusions ①The parents and specialists should pay more recognition to comprehensive assessments before operation. ②The parents should know more information about cochlear implant so as to let the deaf children receive their language rehabilitation in time.③The investigation showed the longer the patients were implanted, the better the aural/oral rehabilitation were developed. We should attach importance to long-term cultivation of hearing and speech rehabilitation.