学龄听障儿童人工耳蜗术后康复效果分析

The Effects of Rehabilitation for the School-age Hearing-impaired Children after Cochlear Implantation

目的：通过对31例7～18岁学龄听障儿童进行人工耳蜗术后康复效果分析，了解其术后康复发展趋势，为探讨学龄听障儿童康复评估和康复指导方案提供参考。方法采用听觉能力、语言能力和语言功能评估标准及方法，以及听觉行为分级标准（categories of auditory performance，CAP）、言语可懂度分级标准（speech intelligibility rating,SIR）分别在患者术后开机、康复第1学期末（术后半年）和第2学期末（术后1年）3个阶段进行跟踪评估，应用统计软件SPSS 16.0对数据进行统计分析。结果3个阶段的听觉能力和语言能力差异均极显著（P＜0.01），语言功能差异不显著（P＞0.05）；听觉能力在开机和第1学期、第2学期的比较均有极显著差异（P＜0.01），但第1学期和第2学期的比较差异无显著意义（P＞0.05）；语言能力各阶段之间的差异均有显著意义（P＜0.05）。听觉行为分级各阶段之间差异有显著意义（P＜0.05）或极显著意义（P＜0.01）；言语可懂度在开机和第1学期、第2学期的比较差异有极显著意义（P＜0.01），但第1学期和第2学期比较，差异无显著性意义（P＞0.05）。结论术后开机半年是学龄听障儿童听觉能力的飞速发展阶段，语言能力和言语可懂度至少需经历1年康复训练才会逐步提高，语言功能需更长时间的康复训练。

Objective To analyze the effects of rehabilitation for 31 cases of school age children of 7 to 18 years old with hearing impairment after cochlear implantation.Methods The assessment was carried for the hearing levels, language ability and language functions, categories of auditory performance （CAP） and speech intelligibility rating （SIR） respectively in boot after cochlear implantation, the first semester and second semester. The data was analyzed using SPSS 16.0.ResultsThe hearing abilities and language skills are statistically different （P〈0.01）. The language functions show no significant differences （P〉0.05）.The comparisons of the hearing levels upon the turn-on of the CI and the first semester, second semester indicate significant increase （P〈0.01）, but the difference was insignificant between the first and the second semester（P〉0.05）. The CAP differences between the results of each stage were significant（P〈0.05） or extremely significant（P〈0.01）. The comparisons of the SIR among the turn-on, the first semester, and the second semester were extremely significant（P〈0.01）, but the difference was not significant between the first and the second semester（P〉0.05）.Conclusion The hearing abilities have improved quickly in the first semester. The language abilities will need at least one year to get improved while the SIR need even more time. The development of language functions requires individualized rehabilitation guidance and integrated education.