大龄语前聋患者人工耳蜗植入术后康复效果评估

Evaluation of Rehabilitation Outcomes after Cochlear Implantation in Later-Implanted Patients with Prelingual Deafness

目的探讨大龄语前聋患者人工耳蜗植入术后听觉、言语识别能力、生活质量等康复情况。方法选取解放军第九八〇医院耳鼻咽喉头颈外科行单例人工耳蜗植入术的大龄语前聋患者38例进行研究,其中8~17岁19例,为研究组(A组),18~39岁19例,为对照组(B组)。所有患者均开机半年,收集所有患者术前临床资料,术前及术后半年评估患者听觉能力、言语可懂度、生活质量(基本声音感知、高级声音感知、言语能力、自信心、活动能力、社会交流能力)、安静条件下单音节词识别率、双音节词识别率、安静条件下语句识别率等,比较两组手术前后评估结果。结果人工耳蜗植入后半年,患者听觉能力、言语可懂度、生活质量评分、言语识别率较术前有明显提高,患者的生活质量及与言语识别有明显相关性,术后半年,两组的差异无统计学意义(P>0.05)。结论人工耳蜗植入对提高大龄语前聋患者的生活质量和言语识别能力有显著效果,生活质量与言语识别能力间的相关性需进一步探讨,手术前后相关评估有助于对治疗效果进行合理评估,在预防并发症、评估疗效、手术难度等方面具有重要意义。

Objective To explore the early rehabilitation of hearing,speech recognition and quality of life of older prelingual deaf patients after cochlear implantation.Methods 38 patients with prelingual deafness who underwent cochlear implantation in the Department of Otolaryngology,Head and Neck Surgery,980 Hospital of Chinese PLA were enrolled in this study.Nineteen patients aged 18-39 years were selected as the control group(Group B).All the patients received cochlear implants and turned on for half a year.Preoperative clinical data were collected.Preoperative assessment included hearing ability,speech intelligibility,quality of life(basic sound perception,Advanced sound perception,speech ability,self-confidence,motor ability,social communication ability),monosyllabic,disyllabic,sentence recognition rate under quiet conditions,etc.Six months after cochlear implantation,the above indicators were re-evaluated and compared before and after surgery and between the two groups.Results Six months after cochlear implantation,the patients'hearing ability,speech intelligibility,quality of life and speech discrimination score were significantly improved.There was no significant difference between the two groups(P>0.05).Conclusion Cochlear implant has a significant effect on improving the quality of life and speech recognition ability of older prelingual deaf patients.The correlation between quality of life and speech recognition ability needs to be further explored.The preoperative and postoperative evaluation is helpful to evaluate the treatment effect reasonably,which is of great significance in preventing complications,evaluating the curative effect and the difficulty of operation.