不同助听模式儿童听觉言语康复效果与家庭生活质量  

Effects of Different Aiding Modalities in Children on Auditory and Speech Rehabilitation and Family Quality of Life

作　　者：孙琴枝 刘佩 葛蕾 汪璐璐 朱子秀 胡翠霞[1] 张标新[1] SUN Qinzhi;LIU Pei;GE Lei;WANG Lulu;ZHU Zixiu;HU Cuixia;ZHANGBiaoxin(Department of Otolaryngology Head and Neck Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;不详)

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科,合肥230022 [2]安徽医科大学第一附属医院生殖中心

出　　处：《中华耳科学杂志》2024年第3期398-404,共7页Chinese Journal of Otology

基　　金：安徽医科大学自然科学研究类项目(2020xkj156);安徽医科大学2021年度校级质量工程项目(2021xjjyxm38);安徽省教育厅2022年度新时代育人质量工程项目(2022zyxwjxalk061)。

摘　　要：目的 探讨不同助听模式的语前聋儿童听觉言语康复效果、家庭生活质量及两者间的相关性。方法 选取2020年3月至2020年7月在安徽医科大学第一附属医院行人工耳蜗植入术的语前聋儿童75例,其中58例符合纳排标准且连续随访1年而被纳入研究,按助听模式将儿童分为单侧人工耳蜗植入组(CI)21例,双耳双模式组(CI+HA)8例,双侧人工耳蜗植入组(BCI)29例。采用听觉能力分级标准(categories of auditory performance,CAP)评分、言语可懂度分级标准(speech intelligibility rate,SIR)评分、父母版言语空间特性量表(speech,spatial and qualities of hearing scale-parent's version,SSQ-P)评分及听力植入体儿童的家庭生活质量表(children using hearing implants quality of life,CuHI Qol)评估患儿听觉言语能力和家庭生活质量。结果 术前CI组、CI+HA组、BCI组CAP评分、SIR评分、SSQ-P评分比较,差异无统计学意义(P>0.05);术后3、6、12个月BCI组CAP评分、SIR评分、SSQ-P评分均高于CI+HA组,差异均有统计学意义(P<0.05);CI+HA组CAP评分、SIR评分、SSQ-P评分均高于CI组,差异均有统计学意义(P<0.05)。CI组、CI+HA组、BCI组言语感知评分、空间听力评分、听力音质评分、SSQ-P评分组间效应、时间效应、交互效应比较,差异均有统计学意义(P<0.05)。随时间延长,CI组、CI+HA组、BCI组SSQ-P评分均呈逐渐递增趋势。CI组、CI+HA组、BCI组不同时间点CuHI Qol评分时间效应比较,差异均有统计学意义(P<0.05),但组间效应、交互效应比较,差异均无统计学意义(P>0.05)。随时间推移,CI组、CI+HA组、BCI组家庭生活质量也越来越高。术后6个月,BCI组家庭生活质量最高,术后12个月,CI+HA组家庭生活质量评分上升明显。CuHI Qol评分与CAP评分、SIR评分、SSQ-P评分呈正相关,差异均有统计学意义(P<0.05)。结论 BCI具备双耳信息整合功能,空间听力优势较双耳双模式及单侧CI更明显,是极佳的助听补Objective To report auditory and speech rehabilitation outcomes and family quality of life in prelingual deaf children and their potential correlations with hearing aiding modes.Methods A total of 75 children with prelingual deafness who underwent cochlear implantation in the First Affiliated Hospital of Anhui Medical University from March 2020 to July 2020 were recruited,of whom 58 met the inclusion criteria and were followed up for 1 year.Children were grouped based on aiding modality,i.e.unilateral cochlear implantation(CI)(n=21),binaural bimodal(CI +HA)(n=8) or bilateral cochlear implantation(BCI)(n=29).The Categorical Auditory Performance scale(CAP),Speech Intelligibility Rating(SIR),Parental Spatial Speech and Qualities of Hearing scale(SSQ-P) and Family Children Using Hearing Implants Quality of Life questionnaire(CuHI Qol) were used to measure children's auditory speech ability and family quality of life.Results Pre-operative CAP,SIR and SSQ-P scores showed no significant difference among the three groups(P>0.05).At 3,6 and 12 months after surgery,these scores were the highest in the BCI group,followed by the CI+HA group and the CI group(P<0.05).Total SSQ-P scores,speech perception,spatial hearing,intergroup effect,time effect and interaction effect all demonstrated statistically significant differences among the three groups(P<0.05).SSQ-P scores showed an upward trend over time in all groups.The CuHI Qol time effect showed statistical significance in all three groups at different time points(P<0.05),but not the inter-group effect or the interaction effect(P>0.05).As time went on,family quality of life continued to improve in all groups.The family quality of life score was the highest in the BCI group at 6 months,and increased significantly in the CI + HA group at 12 months after surgery.CuHI Qol scores were positively correlated with CAP,SIR and SSQ-P scores(P<0.05).Conclusion BCI facilitates binaural information integration,demonstrating a spatial hearing advantage over binaural bi-modal and unilateral

关 键 词：人工耳蜗植入术 双耳双模式 双侧人工耳蜗植入术 语前聋儿童 听觉言语 家庭生活质量 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]