3～6岁儿童人工耳蜗植入后听觉言语能力发育规律探讨

摘要

Objective The purpose of this study is to analyze the auditory and speech abilities of preschool children before and after cochlear implantation by using MAIS and MUSS and to provide clinical evidence for rehabilitation. Methods 61 prelingually hearing-impaired preschool children with cochlear implants participated in this study. The age at cochlear implantation ranged from 36 to 72 months. The audiologists who were trained for the research used the MAIS and MUSS questionnaires. The evaluation was performed before operation and 6, 12, 24, 36, 48, and 60 months after switch-on.Results The score percentages of MAIS were significantly different between pre-operation and 6, 12, 24, 36, 48, and 60 months after switch-on (P<0.05). The scores of MAIS were significantly different between 6 months and 12, 24, 36, 48, and 60 months after switch-on (P<0.05). The score percentages of MAIS were significantly different between 12 months and 36, 48, and 60 months after switch-on (P<0.05). The score percentages of MAIS were significantly different between 24 months and 36, 48, and 60 months after switch-on (P<0.05). The score percentages of MAIS were not significantly different between 36 months and 48, 60 months after switch-on (P>0.05). The scores of MAIS were not significantly different between 48 months and 60 months after switch-on (P>0.05). The score percentages of MUSS were significantly different between pre-operation and 6, 12, 24, 36, 48, and 60 months after switch-on (P<0.05). The score percentages of MUSS were significantly different between 6 months and 12, 24, 36, 48, and 60 months after switch-on (P<0.05). The score percentages of MUSS were significantly different between 12 months and 24, 36, 48, and 60 months after switch-on (P<0.05). The scores of MUSS were significantly different between 24 months and 36, 48, and 60 months after switch-on (P<0.05). The score percentages of MUSS were significantly different between 36 months and 60 months after switch-on (P<0.05). The score percentages of MUSS were not significantly different between 48 months and 60 months after switch-on (P>0.05). The score percentages of MAIS had a significant increase in the first 36 months after switch-on (P<0.05). The scores of MUSS increased significantly,especially in the first 48 months after switch-on (P<0.05).Conclusion After the cochlear implantation, a significant increase in auditory and speech capability occurred, and the development of speech ability was slower than the auditory capability. These two questionnaires could be used for the assessment of cochlear implant outcomes in preschool children.%目的：研究学龄前儿童人工耳蜗植入后听觉言语能力的规律，为制订合理的术后听力言语康复训练计划提供依据。方法选择61例3～6岁语前聋患儿，使用婴幼儿有意义听觉整合量表(meaningful auditory integration scale, MAIS)和有意义使用言语量表（meaningful use of speech scale，MUSS）,由经过培训的听力学专业人员分别在术前和术后开机6、12、24、36、48、60个月对患儿进行评估。结果 MAIS得分在术前、开机后6个月与开机后各评估阶段之间差异均有统计学意义(P<0.05)；开机后12个月与开机后36、48、60个月之间差异均有统计学意义(P<0.05)；开机后24个月与开机后36、48、60个月之间差异有统计学意义(P<0.05)；开机后36个月与开机后48、60个月之间差异无统计学意义(P>0.05)；开机后48个月与开机后60个月之间差异无统计学意义(P>0.05)。MUSS得分在术前开机后6、12、24个月与开机后各评估阶段之间差异均有统计学意义(P<0.05)；开机后36个月与开机后60个月之间差异有统计学意义(P<0.05)；开机后48个月与开机后60个月之间差异无统计学意义(P>0.05)。MAIS得分在36个月内呈显著增长趋势，36个月后进入平台期；MUSS得分在48个月内呈显著增长趋势，之后进入缓慢增长期。结论学龄前患儿人工耳蜗植入术后听觉言语能力均有显著改善，且患儿术后言语能力较听觉能力发展缓慢。该两项问卷可有效用于学龄前人工耳蜗术后儿童的听觉言语能力评估。