语前聋幼儿植入人工耳蜗一年后康复效果评估

Evaluation of the Rehabilitation Effect after Cochlear Implant in the Children with Prelingual Deafness

目的探讨语前聋幼儿人工耳蜗植入术后一年的听觉言语康复效果及影响因素。方法 46例3岁及3岁以内单耳植入人工耳蜗的语前聋患儿分别在植入前及开机3、6、12个月时,应用婴幼儿有意义听觉整合量表(infant-toddler meaningful auditory integration scale,IT-MAIS)、听觉行为分级(categories of auditory performance,CAP)及言语可懂度分级(speech intelligibility rating,SIR),评估听觉言语康复效果,并对不同康复时间、性别、植入年龄、侧别及术前有无助听器佩戴史患儿进行比较。结果随着康复时间的延长46例患儿听觉言语康复效果均逐步提高,开机3、6、12个月时,IT-MAIS得分分别有6(12.5%)、10(20.8%)、7(14.6%)例患儿达到同等听觉年龄的健听幼儿水平;听觉发育(IT-MAIS得分及CAP分级)在前半年的发展速度快于后半年(P<0.01),而言语发育(SIR分级)在前半年和后半年的发展速度差异无统计学意义(P>0.05)。不同性别、植入年龄、植入侧别及术前有无助听器佩戴史患儿间IT-MAIS得分、CAP及SIR分级差异无统计学意义(P>0.05)。结论语前聋幼儿植入人工耳蜗后一年内,听觉言语能力随着康复时间的延长而提高,听能力的前6个月发展较快,而言语发育的进步相对较慢。

Objective To study the effects of auditory speech rehabilitation,change trend and correlated factors in one year after the cochlear implantation.Methods To evaluate the hearing and speech rehabilitation effect in 46 kids(≤3 years old)with prelingual deafness at pre-operation and 3,6 and 12 months after surgery with infant-toddler meaningful auditory integration scale(IT-MAIS),categories of auditory performance(CAP)and speech intelligibility rating(SIR).Results 1.IT-MAIS,CAP and SIR were all gradually improved with the extension of recovery time.2.In different assessment phase of rehabilitation within 1 year,IT-MAIS serves 12.5%-20.8%reached their peers with normal hearing,and the gender,age of operation,implanted side and preoperative hearing AIDS served no significant influence on the assessment results(p>0.05).3.Auditory development(IT MAIS scoring rate and CAP classification)during the first half year developed faster than the latter 6months(p<0.01).However,there was no statistical difference of speech development(SIR)between the two phases(p>0.05).Conclusion Within one year after cochlear implantation,auditory and speech skills increased with the extension of recovery time.Hearing ability can develop faster in the first 6 months and the development of speech is relatively slow.