大龄儿童及青少年人工耳蜗植入后早期认知功能发展的评估

发布时间：2018-05-04 06:11

本文选题：大龄儿童 + 青少年　；参考：《中华耳科学杂志》2017年02期

【摘要】：目的探讨语前聋大龄儿童及青少年人工耳蜗植入后早期认知功能的康复效果。方法采用听觉行为分级(categories of auditory performance,CAP)和言语可懂度分级(speech intelligibility rating,SIR)、数字化远程认知评估系统(electronic cognitive assessment system,E-CAS)对20例5-17岁的语前聋重度或极重度聋患者人工耳蜗植入前后进行听觉、言语、认知功能的评估,分析其听觉及言语获得后大脑认知功能的特点。结果不同年龄组患者人工耳蜗植入后CAP、SIR评分、E-CAS量表得分随植入时间延长呈上升趋势。其中大龄儿童组的同时性加工、注意能力术后6个月末较术前明显提高(P分别为0.02和0.03),青少年组的注意能力术后6个月较术前明显提高(P=0.02)。两组患者计划能力1年后与术前有统计学差异(P0.001)。人工耳蜗植入患者术后1年与健听人在认知功能方面,除注意能力,其余分量表得分仍有明显差异(P0.001)。结论人工耳蜗植入后患者听觉言语及认知功能虽有提高,但认知功能总体认知水平仍处于同龄人低水平,且认知功能需要更长时间的恢复。E-CAS是评估人工耳蜗植入后患者认知功能恢复情况的可用工具。
[Abstract]:Objective to investigate the rehabilitation effect of early cognitive function after cochlear implantation in children and adolescents with prelingual deafness. Methods 20 patients with severe or extremely severe prelingual deafness between 5 and 17 years old were treated with auditory behavior categories of auditory performance (CAP), speech intelligibility rating (SIRN) and electronic cognitive assessment system (E-CAS) before and after cochlear implantation, and the speech and hearing were observed before and after cochlear implantation in 20 patients with severe or extremely severe prelingual deafness. To evaluate the cognitive function and analyze the characteristics of the cognitive function of the brain after hearing and speech acquisition. Results after cochlear implantation, the scores of CAPU Sir score and E-CAS scale increased with the time of cochlear implantation. In the older children group, at the end of 6 months after operation, the attention ability was significantly improved (P = 0.02 and 0.03%, respectively), and the attention ability in the adolescent group (6 months after operation) was significantly higher than that in the pre-operation group (P < 0.05). There was a significant difference between the two groups in planning ability after 1 year compared with that before operation (P 0.001). The cognitive function of cochlear implant patients was significantly different from that of normal hearing people in cognitive function except attention ability (P 0.001). Conclusion although the auditory speech and cognitive function of cochlear implant patients have been improved, the overall cognitive level of cochlear implant patients is still at the low level of their peers. And cognitive function needs longer recovery. E-CAS is a useful tool to evaluate the recovery of cognitive function after cochlear implantation.
【作者单位】：广西壮族自治区人民医院耳鼻咽喉科;广西中医药大学研究生学院;广西壮族自治区人民医院认知睡眠中心;
【基金】：国家自然科学基金资助项目(No:81460097) 广西医疗卫生适宜技术研究与开发课题(No:S201421_05) 广西壮族自治区卫生厅自筹经费科研课题(No:Z2014215、Z2015351、Z2016593及Z2016608)~~
【分类号】：R764.9

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