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  

Evaluation of early cognitive functions in older children and teenager recipients of cochlear implants

作　　者：胥亮[1,2] 刘闽[1,2] 唐凤珠[1] 史敏[1] 瞿申红[1] 梁建平[1] 陆秋天[1] 秦岭[3] 李丹丹[3] XU Liang;LIU Min;TANG Fengzhu;SHI Min;QU Shenhong;LIANG Jianping;LU Qiutian;Qin Ling;LI Dandan(Department of Otolaryngology,People’s Hospital of Guangxi Zhuang Autonomous Region;Guangxi University of Traditional Chinese Medicine;Department of Congnitive and Sleeping,the People’s Hospital of Guangxi Zhuang Autonomous Region,530001,China)

机构地区：[1]广西壮族自治区人民医院耳鼻咽喉科,南宁530021 [2]广西中医药大学研究生学院,南宁530001 [3]广西壮族自治区人民医院认知睡眠中心,南宁530001

出　　处：《中华耳科学杂志》2017年第2期207-212,共6页Chinese Journal of Otology

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)~~

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(P<0.001)。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(P<0.001)。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。Objective To explore the effect of early rehabilitation of cognitive function after cochlear implantationin prelingually older children and teenagers.Methods The categories of auditory performance(CAP),speech intelligibilityrating(SIR)and the electronic cognitive assessment system(E-CAS)were used to evaluate twenty prelinguallyheavy-profound hearing loss patients’auditory,speech performances and cognitive function.The rehabilitation of cognitivefunction was analyzed after cochlear implantation.Results The scores of CAP、SIR and E-CAS in different agesgroups were all increased with time after cochlear implantation.Significance differences in the older childrens’simultaneousprocessing capacity(P=0.02),attention capacity(P=0.03)and in the teenagers’attention capacity(P=0.00)wereobserved at the end of the6th month after cochlear implantation.Significance differences in planning processing capacity of two groups at the end of1year(P<0.001).But normal people’s score is still higher than patients with cochlear implantation(P<0.001).Conclusion Although auditory,language ability and cognitive function are found to be enhancedafter cochlear implantation,but the overall cognitive level is still lower than normal children.The restore of cognitivefuntion needs a longer time.E-CAS is a useful instrument to evaluate the effect of rehabilitation of cognitive functioninchildren after CI.

关 键 词：大龄儿童 青少年 人工耳蜗植入术 康复 认知功能 

分 类 号：R764[医药卫生—耳鼻咽喉科]