成人语后聋患者人工耳蜗植入术后初期状态分析  

Analysis on the initial state of postlingual deafness in adult patients after cochlear implantation

作　　者：李海珍[1] 郑秀瑾[1] 孙雪萍[1] 张文露[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科,100730

出　　处：《中华现代护理杂志》2014年第4期413-415,共3页Chinese Journal of Modern Nursing

摘　　要：目的：总结成人语后聋患者人工耳蜗植入术后的声音察觉及言语感知，探讨成人重获听力的期望值，是否需要进行听力训练及适应交往时间。方法选取2002-2011年成人语后聋人工耳蜗植入术后患者16例，其中9例患者开机即参与训练，1例开机后3个月内在自然环境等待自然康复，无效果而来训练，6例患者一直未参与训练。参与训练者起始在自然的环境中给予乐音、语音不同频率声音的输入测试听力，听力训练每日2 h，单训及合训结合。以听觉言语感知、书写及言语表达等多种综合沟通形式并用，进行为期3～10周的听觉培建。从听觉培建后期开始增加言语训练，注重口语朗读的连贯性及清晰度，考察音义结合及回归适应社会的效果。结果参与训练的10例中，4例耳蜗植入术后开机即刻训练达5周以上，1例间断训练4周，5例短暂（最短3～4 d）训练。6例不参与训练。参与训练大于4周的5例患者《最低听觉功能测试词表》测试总辨别率平均为90．3％，5～7个月逐步适应工作及学习环境，1．5～2．0年可正常交流；短期训练的5例中经《最低听觉功能测试词表》测试3例总辨别率平均为36．0％；2例不能完成测试；未参与训练的6例患者平均术后2年均不能完成测试。结论人工耳蜗植入使语后聋成人获得了重获听力的基础，术后训练使患者重获听力成为现实，训练时间短于语前聋小儿，但仍需到达一定时间。Objective To analysis the re-hearing expectations and the need for auditory training and the time of adaptation exchanges after cochlear implantation .Methods Sixteen cases of adult postlingual deafness, which were selected, from 2002 to 2011, were treated by cochlear implantation .9 cases participated in speech training right after cochlear implantation , and 7 cases didn ’ t participate in speech training .In the initial stage, the patients were given the tone and input hearing test with voice frequency in the natural environment.The auditory training was for 2 hours a day, which included single and combined training .The training method was comprehensive , including auditory speech perception , writing and verbal expression .The training focused on the coherence and clarity of oral Reading .One training course was 3 -10 weeks .The efficacy of the training with the combination of sound and the ability to adapt to society was analyzed . Results In 10 cases joining the training , 4 cases instantly began to auditory training after cochlear implantation and lasted for more than 5 weeks.1 case discontinuously trained for 4 weeks, and other 5 cases trained transiently （ less than 3 ~4 days ） .6 cases refused to participate in the training process after cochlear implantation .Assessed by the “the lowest auditory function test vocabulary”, the distinguish rate of 5 patients was 90.3%after training for more than 4 weeks, who gradually adapted to working and learning environment after 5-7 months, and gained normal communication after 1.5-2.0 years.The distinguish rate of 5 patients was 36.0%after training for several days , and 2 patients cannot accomplish the test .Besides, the 6 patients without participation the training program cannot finish the assessment for over 2 years after cochlear implantation.Conclusions Cochlear implantation provides patients with the possibility of re-hearing, and the postoperative training can help patients in communicating in social life .A variety of factors can affect the effi

关 键 词：听力障碍 耳蜗植入术 听觉 交流障碍 

分 类 号：R764[医药卫生—耳鼻咽喉科]