语前聋儿童人工耳蜗植入术后前语言交流能力发展

发布时间：2018-08-03 09:56

【摘要】：目的分析人工耳蜗植入后儿童前语言交流能力的发展规律,探讨其与其它听觉及言语评价指标的相关性,为早期听觉言语康复评估提供依据。方法对23例接受国产人工耳蜗植入术的语前聋儿童进行一年的随访,手术月龄12~66个月,平均35±3个月。分别于开机时及开机后1、3、6、9、12个月使用录像分析法对患儿的轮流交流、主动交流、视觉交流及听觉注意4项前语言交流能力进行分析和评估;同时使用听觉行为分级(CAP)、言语可懂度分级(SIR)问卷对其听觉和言语能力进行评估。结果随术后开机时间延长,患儿的轮流交流和听觉注意能力呈显著增长趋势(P0.05),前6个月增长较快(P0.05),后6个月缓慢增长(P0.05);患儿主动交流和适时的视觉交流能力得分较低,两者差异无统计学意义(P0.05);患儿CAP和SIR得分与轮流交流和听觉注意能力相关。结论随着人工耳蜗使用时间的延长,患儿逐步建立了听/说的交流模式;前语言能力评估结果与CAP和SIR得分有相关性,三者结合可相互印证并能更全面准确地对人工耳蜗植入术后儿童早期听觉、语言和交流能力进行评估。
[Abstract]:Objective to analyze the development of children's pre-speech communication ability after cochlear implantation, and to explore its correlation with other auditory and speech evaluation indexes, so as to provide basis for early auditory speech rehabilitation evaluation. Methods Twenty-three children with prelingual deafness underwent domestic cochlear implantation were followed up for one year. The operative age was 12 ~ 66 months (mean 35 卤3 months). Video analysis was used to analyze and evaluate the four preverbal communication abilities of the children at the time of boot and 1: 3 / 6 / 12 months, respectively, including rotational communication, active communication, visual communication and auditory attention. At the same time, auditory behavior rating (CAP), speech intelligibility rating (SIR) questionnaire was used to evaluate its hearing and speech ability. Results with the extension of the time after operation, the children's alternating communication and auditory attention ability increased significantly (P0.05), the first 6 months (P0.05), the latter 6 months slowly (P0.05), the scores of children's active communication and timely visual communication were lower. There was no significant difference between the two groups (P0.05); the scores of CAP and SIR were correlated with the ability of rotational communication and auditory attention. Conclusion with the prolongation of cochlear implantation time, the auditory / speaking communication model was gradually established, and the results of preverbal ability assessment were correlated with the scores of CAP and SIR. The combination of the three methods can confirm each other and evaluate the early hearing, language and communication ability of children after cochlear implantation more comprehensively and accurately.
【作者单位】：首都医科大学附属北京同仁医院北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学);首都医科大学附属北京儿童医院儿童听力诊疗中心儿童耳鼻咽喉头颈疾病北京市重点实验室;
【基金】：首都卫生发展科研专项项目(首发2011-1017-01) 卫生行业科研专项基金(201202001) 首都市民健康项目培育专项(Z141100002114033) 北京市卫生系统高层次卫生技术人才培养计划基金(2009-3-29) 首都医科大学基础-临床科研合作基金重点项目(12JL12)资助
【分类号】：R764.43

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