语前聋儿童人工耳蜗植入后言语康复的影响因素分析

Analysis of Factors Influencing Speech Rehabilitation in Children with Prelingual Deafness after Cochlear Implantation

目的探讨语前聋儿童人工耳蜗植入后言语康复效果的影响因素。方法选取2014年5月~2018年7月在南京市儿童医院进行人工耳蜗植入的102例患儿,按照植入年龄、性别、人工耳蜗品牌、看护人文化水平进行分组,应用有意义言语使用量表(MUSS)和言语可懂度分级标准(SIR)问卷对患儿术后开机3月、6月、12月的言语康复效果进行评分。结果随着开机时间的增加,所有患儿的MUSS和SIR评分均逐渐提高(P<0.05)。B组患儿(植入年龄25~101月)的MUSS评分均优于A组(植入年龄9~24月),其差异具有统计学意义(P<0.05);B组患儿的SIR评分在开机后12月显著优于A组患儿(P<0.05)。性别和人工耳蜗品牌的差异对患儿的MUSS和SIR评分没有显著影响(P>0.05)。看护人文化水平为高中以上的患儿不同开机时间的MUSS评分均显著高于看护人文化水平为高中以下的患儿(P<0.05);术后开机3个月的患儿的SIR评分无明显差异,开机6个月和12个月的患儿,其看护人文化水平为高中以上的SIR评分显著高于看护人文化水平为高中以下的患儿(P<0.05)。结论语前聋儿童提倡尽早植入人工耳蜗,随着开机时间的增加,患儿的言语康复效果逐渐提高。在选择康复中心语训的同时注重家庭语训,并且选择文化水平较高的看护人。

Objective To evaluate the influencing factors on speech rehabilitation of prelingual deaf children with cochlear implants. Method A retrospectively review was conducted in 102 prelingual deaf children, who were implanted at Children’s Hospital of Nanjing Medical University between May 2014 and July 2018. Rehabilitation outcomes were assessed at 3, 6 and 12 months after switch-on according to implant age, gender, cochlear brand and caregiver’s education level. Results The MUSS and SIR scores of all children increased obviously with starting to use cochlear(P<0.05). The MUSS scores of children in Group B(implant age between 25-101 months) were all better than the children in Group A(implant age between 9-24 months, P<0.05). The SIR scores of children in Group B were better than the children in Group A when the using time was 12 months(P<0.05). The gender and cochlear brand had no significant effect on the scores of MUSS and SIR(P>0.05). The MUSS scores of children whose caregivers’ education level above high school were all higher than those below high school(P<0.05). However, there was no significant difference in SIR scores of children no matter the caregivers’ education levels were above high school or below high school when the using time was 3 months(P>0.05), while the SIR scores showed obvious difference when the using time was 6 months or 12 months(P<0.05). Conclusion Children with prelingual deafness should be implanted as soon as possible. With the increasing of using time, the effect of speech rehabilitation of children was gradually improved. During the period of rehabilitation, the caregivers with higher level education were preferred.