广西少数民族农村地区聋儿听力干预情况分析58例

Intervention Effects of Children with Hearing Loss in Minority Groups in Guangxi Rural Areas

目的了解广西少数民族农村地区中至极重度聋儿的听力干预情况。方法研究对象为2006年1月至2009年12月在柳州市妇幼保健院听力诊断中心诊断为双侧中至极重度聋的58例患儿,年龄3～72个月,中位数22个月,由专人采集病史,对家长进行电话调查,了解患儿确诊后是否接受助听器或人工耳蜗植入以及听力语言训练、语言发育及交流能力,聋儿的走向和成效跟踪等情况进行调查。结果 58例聋儿中(男31例,女27例),其中壮族24例、苗族9例、瑶族6例、侗族10例、仫佬族4例、毛南族2例,水族2例,回族1例。其中13例是通过听力筛查发现,其他45例经由家长发现。58例患儿中,接受选配助听器31例(53.45%),人工耳蜗植入2例(3.45%).在31里接受助听器的患儿中,助听后进行语训12例(38.71%),助听后无语训19例(61.29%);共有25例聋儿未得到干预(43.10%)。31例佩戴助听器的聋儿中只有6例语言发育较好,其余25例存在不同程度的语言障碍,在这25例中有2例患儿进入当地特殊教育学校就读,采用看口型、手语交流。2例人工耳蜗植入者语言发育较好,未干预的25例处于聋哑状态。结论广西少数民族农村地区中至极重度聋患儿,无助听干预和无语训比例偏高,言语障碍较明显,主要原因在于普遍新生儿听力筛查工作起步较晚,以及家长对聋儿佩戴助听器和语训必要性的认识不足,基层农村聋儿康复教育设施建设落后等。

Objective To investigate the effects of the intervention,rehabilitation and speech development of children with moderate to severe hearing loss in minority groups in rural areas of Guangxi.Methods Totally 58 cases of hearing loss children who failed hearing screening or visited the hospital as outpatients were analyzed in this study.Among these 58 children（31 males and 26 females） ,the ethnic minority distribution is as the following：24 cases of the Zhuang,9 cases of Miao,6 cases of Yao,10 cases of Dong,4 cases of Mulam,2 cases of Maonan,2 cases of Shui,1 case of Hui.All these 58 children were diagnosed as moderate to severe hearing loss with ABR and ASSR from January 2006 to December 2009.A questionnaire regarding the usage of hearing aids,hearing and speech rehabilitation,speech development,and communication ability was used to collect data via telephone follow-up inquiry.Results 31（53.45%） ） children were provided hearing aids,and 2（3.45%） received cochlear implants,while the rest 25 children（43.10%） did not receive hearing aids nor cochlear implants.Twelve of 31 who provided with hearing aids also had speech training,Six cases from the 31 children who had hearing aids,plus those two children who received cochlear implants were found to have good speech development and communication ability,whereas those 25 cases with hearing aids had delayed speech development.The rest 25 cases without any hearing aids or treatment had to rely on sign language for their communication.Conclusion Children in rural areas of Guangxi with moderate to severe hearing loss experienced greater speech and communication difficulty because many of them had no access to intervention and speech training.Other reasons such as delay start of universal newborn hearing screening,parents’inadequate of knowledge and awareness for hearing aids and language training,laggard rehabilitation education and facilities in rural rehabilitation of deaf children and other factors.