359例人工耳蜗植入儿童听觉康复效果发展趋势研究

目的分析359例人工耳蜗植入儿童术后1年的听觉能力发展趋势，为实施康复效果质量监控与进一步改善安置策略提供指导。方法依照人工耳蜗植入年龄进行分组，以术后不同的安置时段（3个月，6个月、9个月和12个月）为重复测量条件，采用方差分析的方法，利用SPSS16．0软件评估不同年龄段人工耳蜗植入儿童术后安置1年内听觉能力随时间顺序变量变化的趋势。结果①接受人工耳蜗植入的儿童在术后1年安置中其听觉言语识别率随着安置时段的延续，总体上呈线性（＊＊P=0．000〈0．01）和二次性（＊＊P=0．000〈0．01）上升变化的趋势②在听觉言语识别能力获得方面，2～4岁组间，4～6岁组间存在相近的变化趋势（P〉0．05）。但7岁组与其他各年龄组、2～3岁组与5～6岁组间变化趋势差异显著（＊P〈0．05）；③比例差异系数（coefficients of variation,CV）的比较显示，随着术后安置接受训练时间的延续，各年龄组的听觉言语识别率平均值的标准差变小。结论①康复安置策略总体上是有效的；②在术后康复安置策略保持一致的情况下，人工耳蜗植入聋儿的听觉康复效果，主要受到来自人工耳蜗植入年龄和术后接受康复训练时间长短两个要素的交互影晦③人工耳蜗植入儿童不同年龄组间听觉能力的发展速度随着术后康复训练时间的延续，出现非等速均匀发展的特点。

A study on the postoperative hearing development trends of 359 children with CI

Objective To analyze the trends for the hearing improvement of 359 children with CI over one year postoperative training and to provide the guidance for rehabilitation supervision and further implementation of postoperative rehabilitation strategies. Methods Children were grouped by the ages of cochlear implantation, and assessed at different postoperative periods （at 3, 6, 9 and 12 months respectively）. An analysis of variance was used to assess the hearing development trends within one year after CI operation for children of different age groups with SPSS16.0 software. Results （1）The hearing and speech recognition rates（%） for children with CI showed a linear （＊＊P=0.000〈0.01）and quadratic （＊＊P=0.000 〈0.01） trends of increase within one year after the operation. （2）There were similar trends between 2,3 and 4-year-old group and between 4,5 and 6-year-old group （P〉0.05） in the acquisition of hearing and speech recognition ability. However, there were significant differences between 7-year-old group and the other groups, between 2-3-year-old group and 5-6-year-old group （＊P〈0.05）. （3）The comparison of coefficients of variation （CV） indicated that the average standard deviation of hearing and speech recognition rate decreased over time of training. conclusions（1）The hearing assessment results of 2-7-year-old children with CI showed that the rehabilitation strategies were effective for hearing-impaired children. （2）When children with CI were given the same rehabilitation strategies, the age of implantation and the training time were two key factors imposing interactive influence on rehabilitation outcome. （3）The hearing ability development was non-uniform among different age groups as time went on.