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低龄聋儿人工耳蜗植入后听觉语言发展期的观察

Effect research of deaf children with time after coclear implantation
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摘要 目的回顾性观察低年龄段聋儿人工耳蜗植入后对言语和环境声的认知以及语言交流情况,并分析其随使用时间的变化规律。方法北京协和医院自开展人工耳蜗植入以来共进行了1400余例人工耳蜗植入术,本文选择植入耳蜗时年龄小于3岁且耳蜗结构正常的患儿125例作为研究对象,并按照使用耳蜗装置的时间进行分组:使用时间在0.5~1年为第1组,1~2年为第2组,2~3年的为第3组,3~5年的为第4组,5年以上的为第5组,每组各选择25例。运用青少年儿童及婴幼儿听说能力评估问卷家长观察记录表(Parients′Evaluation of Aural/Oral Performance of Children,PEACH),以问卷的形式,了解低年龄段患儿在植入人工耳蜗后装置的使用情况、对言语和环境声的感知及理解能力、日常生活中的语言交流能力以及电话交流能力等。结果耳蜗装置使用舒适度情况,各组之间无明显差别;安静环境下与噪声环境下随使用时间变化的发展情况并不完全一致,每一组安静状态下的得分比均较噪声状态下的得分比高,除第1组外均有统计学差别;将电话交流这一项抽出后所得的安静下得分比与包括电话交流这一项的安静下得分比之间也存在差别,前者要好于后者,除第3组外,其余各组两项之间均有统计学差别;在电话交流能力这一项中,3、4、5组之间无统计学差别。结论对于低年龄段聋儿,接受人工耳蜗植入后,在使用耳蜗装置半年后基本适应,之后均能处于较舒适的使用状态。随着耳蜗装置使用时间的延长,对言语和外界声音的感知能力、语言交流能力以及电话交流能力,总的趋势是逐渐提高,但在5年之后进入平台期,之后基本维持这一水平;在应用耳蜗装置3年以后,安静环境下各项能力的提高基本进入稳定状态,之后不再有明显的进步;在噪声环境下,使用装置0.5~2年期间进步明显,在第2-3年期间时,进步较缓慢,到第3年初时,患者听觉认知及言语交流等能力再次明显提高,从第5年开始,再次进入平台期,能力的提高近似达到饱和;用耳蜗装置的2年内,电话交流能力有明显且较大幅度的提高,从使用2年后开始进入缓慢且持续的进步期,电话交流能力的发展似乎应该是从第4或第5年开始进入平台期。 Objective Retrospectively observe the auditory perception, speech recognition and intercourse of deaf young children after cochlear implantation. Methods 125 of more than 1400 patients who accepted cochlear implants in PUMC hospital were researched in this article.They were selected by the criterion:less than 3 years in age and more than half a year in using artificial cochlea.All the 125 patients were divided into 5 groups accoding to the period of the use of artificial cochlea, including 0.5~1 year for the first group,1 ~2 yearsfor the second group, 3 ~ 5 years for the fourth group,and more than 5 years for the fifth group,and there were patients in every group. We made use of Parients' Evaluation of Aural/Oral Performance of Children (PEACH) as questionnaire to investigate how about the auditory perception, speech recognition and intercourse ,and telephone communication.of deaf young children after cochlear implantation. Results There was no statistic difference for comfortable use of artificial cochlea and there was statistic difference about scores between quiet environment and noise environment except the first group.There was statistic difference for telephone communication scores except the third,the fourth and the fifth groups. Conclusions Deaf children could feel comfortable to artificial cochlea since received cochlear implants for half a year.Since the use of artificial cochlea,the auditory perception, speech recognition and intercourse in routine life improved well in five years in overview.And the effect was stable after 3 years in quiet environment and 5 years in noise environment except the unconspicuous development between the second and the third year. The ability of telephone communication improved quickly in 2 years after cochlear implants and advanced slowly until 4 or 5 years.Then there was scarecely any development.
出处 《中国中西医结合耳鼻咽喉科杂志》 2009年第4期193-197,188,共6页 Chinese Journal of Otorhinolaryngology in Integrative Medicine
关键词 人工耳蜗 幼儿 时间 效果 Cochlearirnplant Children Time Effect
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参考文献9

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