225例人工耳蜗植入儿童术后康复效果评估

摘要

Objective The purpose of the present study was to study the relationship between rehabilitation outcomes and the age at implantation as well as the duration of implant use, and to compare the standardized assessment procedures in China and those commonly used internationally. Methods Two hundred twenty five children who received cochlear im-plants in our hospital in recent years were identified and separated into two groups based upon if their ages were older than 3 years or not at implantation. Their clinical data were reviewed and their speech perception and production prior to, and at third, sixth, ninth, twelfth months after device activation were evaluated. Their CAP and SIR scores were collected through questionnaires at each assessment interval. Results The overall rehabilitation level improved along with the increase of du-ration of implant use. The performance in children who were younger than 3 years at implantation improved more rapidly in speech perception and production as compared with the other children, although there was no remarkable difference in the rate of CAP and SIR improvement between the two groups. There were prominent positive correlations between speech per-ception rate and CAP, and between speech age and SIR. There was no statistically significant difference between the two types of implant. Conclusion Two of the most important factors affecting post-operational rehabilitation results are age at implantation and duration of implant use. The younger the age at implantation and the longer the duration of implant use, the better the rehabilitation results. The standardized assessment procedures used in China are comparable to those com-monly used internationally on some aspects and they can be used in a complementary manner, although they cannot replace each other completely.%　　目的对225例语前聋患儿进行一年的术后跟踪评估，探讨植入时年龄及康复时间与康复效果的关系,以及分析国内标准化评估程序与国际通用评估方法之关系，是否具有可比性。方法收集近年来在我院施行人工耳蜗植入术的语前聋患儿225例的详细资料，按植入时的年龄将研究对象分为2组(3岁以上组与3岁以下组),分别在人工耳蜗植入术前与术后3、6、9、12个月评估其言语听觉能力与语言能力,并通过问卷方式获得其CAP和SIR评级得分并记录。结果术后康复总体效果随着康复时间延长而逐步提高,3岁以下组在言语感知及语言能力上提升较3岁以上组快，CAP和SIR评级提升速率两组未见显著统计学差异。言语识别率与CAP评级，语言年龄与SIR评级之间分别存在显著正相关性。两种类型植入体的康复效果未见显著区别。结论植入时年龄与康复时间是影响康复效果的两大重要因素，植入年龄越小，康复时间越长效果越好。国内常用的标准化评估程序与国际通用评估方法具有一定程度的同等说明性，可互为参考，但两者不可完全相互替代。