中度以上听力障碍患儿助听器或人工耳蜗植入后语言发育状况分析  

Outcome Study of Two Intervention Strategies on the Language Development of Young Children with Hearing Loss Greater than Moderate Degree

作　　者：李蕴[1,2,3] 陈向平[1] 陶铮 吴皓[2,3] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉-头颈外科,上海200092 [2]上海市儿童听力障碍诊治中心 [3]上海交通大学医学院耳科学研究所 [4]上海儿童医学中心耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2010年第2期176-179,共4页Journal of Audiology and Speech Pathology

基　　金："十一五"国家科技支撑计划(2007BAI18B12);上海市优秀学科带头人计划(08XD1402900);上海交通大学医学院科技基金项目(09XJ21042)联合资助

摘　　要：目的分析中度以上听力障碍患儿接受不同干预方式后语言发育状况。方法2002年1月至2007年12月确诊为中度以上听力障碍的患儿65例（年龄10～41个月，平均22．38～3．8个月），于出生后6个月开始接受听力干预，根据听力障碍程度和干预方式分为中度听力障碍助听器干预组（MHA组）20例、重度听力障碍助听器干预组（SHA组）19例、极重度听力障碍助听器干预组（PHA组）9例和极重度听力障碍人工耳蜗干预组（PCI组）17例；未接受干预者36例为未干预组；年龄、性别相当的听力正常儿童36例为对照组。以声场下纯音听阈或听性稳态反应（ASSR）评估各组干预前后的听力状况，采用Gesell发育量表评估语言发育商，并进行统计学分析。结果未干预组的语言发育商和听力状况比对照组差（P〈0．05），所有干预组的语言发育商和听力状况均比未干预组好（P〈0．05）；MHA组、SHA组、PCI组与对照组的语言发育商和听闾水平差异无统计学意义（P〉0．05）；PHA组语言发育商落后于PCI组（P〈0．05）。结论中度以上听力障碍患儿早期干预效果良好，极重度听力障碍患儿人工耳蜗植入后语言能力好于配戴助听器者，根据听力障碍程度选择合适的干预方式是获得良好语言水平的重要保证。Objective To study the outcomes of two intervention strategies on the language development of young children with hearing loss greater than moderate degree by universal newborn hearing screening （UNHS） system. Methods Infants and young children, born from Jan 2002 to Dec 2007 in Shanghai and failed UNHS, were ineluded in this study. They received audiometric evaluations at the Shanghai Children＇s Hearing and Speech Center. Among those diagnosed with hearing loss greater than moderate degrees, 65 were intervened at 6 months and followed up subsequently. According to hearing loss degree and intervention strategies, 20 of 65 were included in the hearing aid group（MHA）, 19 was in the severe hearing aid group（SHA）, 9 in the profound hearing aid group（PHA）, and 17 in the profound cochlear implantation group（PCI）. Other 36 were not intervened at 6 months old but followed up also. The control group was 36 normal hearing young children. The hearing losse and speech development were analyzed for statistical study. Results Between the group without intervention and the control group, between the group intervened and without intervention, statistically significant differences were noted （P〈0. 05） in the average hearing threshold and the developmental scores. Between the control group and anyone group among MHA , SHA and PCI, no statistically significant differences （P〉0. 05） were noted in the developmental scores. For the same hearing level between the group PHA and Pc1, statistically significant differences （P〈0. 05） were noted in the developmental scores. The developmental scores of PHA was lower than that of PCI. Conclusion Early intervention is effective for infants and young children with hearing loss greater than moderate degree. Their speech development is noticeably faster than that of those without any intervention. According to hearing loss degree, it was very important for acquiring the best speech development that selected the most proper intervention mode.

关 键 词：听力障碍 干预 助听器 人工耳蜗 语言 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]