伴有听力障碍的多残儿童人工耳蜗疗效分析

目的 探讨多残儿童人工耳蜗植入手术的经验及问题。方法 我院近年来开展多导人工耳蜗植入术600余例，对其中8名多残儿童开展了多导人工耳蜗植入手术。8名患者中，深度感音性聋同时合并智障与脑瘫者1例，余合并智障者2例，其中一例智障患者合并Mondini畸形，合并脑瘫者3例，Usher’s综合症2例。对这8例患者进行回顾性分析，随访3～5年。就术后开机调试特点，术后听力言语康复效果以及存在的问题等进行讨论。结果 （1）术后无面瘫、脑脊液漏、脑膜炎等手术并发症；（2）手术后护理比常规人工耳蜗术后病人复杂：病人哭闹、卧床困难、输液困难、不配合医护人员工作等；（3）开机调试后所有术后多残儿童都有听觉反应，除1例听到声音后极为恐惧外，其余患者都非常兴奋，但调试比较困难，患者配合程度差，有时一个病人需要多次调试才能获得结果，增加了调机人员的工作难度；（4）经过艰苦的康复训练，言语辨别率比术前明显提高，家长对此很满意。结论 伴有多种残疾的深度感音性聋患者可以行人工耳蜗植入，术后增加了一个全新的康复手段，从而为整个康复计划起到了推动作用，减轻了患者家庭和社会的负担，但增加了医护人员术后护理、调机以及康复上的工作难度。

Cochlear implantation in multihandicap children

Objective The life quality of the muhihandicap children is extremely poor. In addition to the hearing impairment , they also have other disability. Outcome data and the quality of life from 8 prelingually pediatric muhihandicap patients who received cochlear implants are discussed. Methods Among 600 patients who received multi- channel cochlear implants from 1996 to 2006 in Beijing Tongren Hospital , 8 patients were hearing impaired children associated with other .disability. A retrospective analysis was performed to deal with the surgical techniques, mapping, rehabilitations characteristics and quality of life after surgery. Results The 8 children implanted at our center have not had any postoperative medical or cochlear implant device complications. The nursing, mapping and rehabilitation after surgery was more complicated than other cases. Although can not improve significantly, every cases followed-up have benefited from cochlear implantation. Conclusion Our experiences with cochlear implantation for children with multihandicap have been very positive. The 8 children we have implanted have not had any complications postoperatively. The 5 cases followed-up all have shown improved listening and communication skills and quality of life. The auditory rehabilitation play a positive role to the entire rehabilitation.