脑白质异常的语前聋患儿人工耳蜗植入术后康复效果分析

The Rehabilitation Effects of the Cochlear Implantation on Prelingually Deaf Children with Alba Abnormality

目的评估脑白质异常的语前聋患儿人工耳蜗植入(cochlear implant,CI)术后康复效果。方法对行CI的11例伴脑白质异常(研究组)及18例脑组织正常(对照组)的语前聋患儿于CI术后6个月及12个月采用听觉行为分级标准(categories of auditory performance,CAP)和言语可懂度分级标准(speech intelligibility rate,SIR)进行康复效果评估,分析其结果。结果术后6个月时研究组患儿CAP平均分级为2.41±0.47级,SIR平均分级为1.27±0.44级,而对照组患儿CAP平均分级为3.28±0.45级,SIR平均分级为1.89±0.31级,研究组患儿CAP和SIR平均分级均低于对照组,差异有统计学差异(t=4.983,P<0.05;t=4.371,P<0.05);术后12个月时研究组患儿CAP平均分级为4.00±0.43级,SIR平均分级为2.36±0.48级,对照组患儿CAP平均分级为4.22±0.63级,SIR平均分级为2.44±0.50级,两组间CAP和SIR平均分级差异均无统计学意义(P>0.05)。结论脑白质异常的语前聋患儿CI术后经过12个月的康复训练,其康复效果与脑白质正常的语前聋患儿无明显差异。

Objective To study the rehabilitation effects of the cochlear implants on prelingually deaf children with alba abnormality.Methods A retrospective analysis of the effects of CIs was conducted in the prelingually deaf children of 11 cases of the children with abnormal alba（the research group）and 18 cases of the children who had normal alba（the control group）at the First Affiliated Hospital of Fujian medical university.All the operations were completed by the same doctor.There were no obvious complications during and after the operation.The cochlear implants were turned on after one month and the prelingually deaf children with extremely severe bilateral sensorineural deafness were trained for speech at the rehabilitation centre.The assessment criteria of the categories of auditory performance（CAP）and speech intelligibility rate（SIR）were used.After six months and twelve months of the operation,the family members were followed who have direct contacts with the children.The evaluation of data between the research and the control groups was administered.Results In the research group,the average level of CAP after six months＇ post-operation was 2.41±0.47.But in the control group,the average level was 3.28±0.45.In the research group,the average level of SIR after six months＇ post-operation was 1.27±0.44.There were 3children in the research group at level 2,but in the control group,the average level was 1.89±0.31.Two children in the control group were level 1while the others were level 2.In the research group,the average level of CAP after twelve months＇ post-operation was 4.0 0±0.4 3while only one child at level 3.There was one child atlevel 5in the research group,the rest were level 4.There was a statistically significant difference in the average level of the CAP after six months＇ post-operation（t=4.983,P〈0.05）and in the average level of the SIR after six months＇ post-operation（t=4.371,P〈0.05）.There was no statistical difference in the average level of the CAP after twelve months＇ post-operation（t=1.033,P〈0.05）and in the average level of the SIR after twelve months＇ post-operation（t=0.434,P〈0.05）.Conclusion There is no significant difference of the rehabilitation effects of post-operation between the prelingually deaf children with alba abnormality and those with normal alba.