中度和重度聋儿助听后早期听觉能力及言语可懂度发育

目的：评价耳聋儿童助听后1年内听觉及言语能力发展变化趋势，探讨耳聋程度对聋儿的听觉及言语发育水平的影响，为聋儿的有效康复提供临床参考资料。方法：患儿29例，男19例，女10例。助听器选配年龄3～8岁，平均5．6岁。根据听力损失程度将患儿分为中度听力损失组（14例）和重度听力损失组（15例）。分别使用听觉行为分级（CAP）和言语可懂度分级（SIR）问卷在助听前及助听后1、3、6、9、12个月时对患儿的听觉能力及言语可懂度发育情况进行评估。结果：经单因素方差分析，中度和重度聋患儿CAP平均得分在助听前差异有统计学意义（P〉0．05）。在助听后1、3、6、9、12个月均差异无统计学意义（P〉0．05）。同样中度和重度聋患儿SIR平均得分在助听前差异有统计学意义（P〈0．05）。在助听后1、3、6、9、12个月均差异无统计学意义（P〉0．05）。中度聋患儿cAP平均得分助听前与助听后6、9、12个月差异有统计学意义（P〈0．05）。中度聋患儿SIR平均得分助听前与助听后6、9、12个月差异有统计学意义（P〈0．05）；助听后1个月与12个月差异有统计学意义（P〈0．05）。重度聋患儿CAP平均得分助听前与助听后3、6、9、12个月差异有统计学意义（P〈0．05），助听后1个月与9、12个月差异有统计学意义（P〈0．05）。重度聋患儿SIR平均得分助听前与助听后3、6、9、12个月差异有统计学意义（P〈0．05），助听后1个月与6、9、12个月差异有统计学意义（P〈0．05）。结论：中度和重度聋组患儿助听后1年内早期听觉及言语能力有显著提高，但各自有不同的发育特点和规律。

The development of auditory performance and speech intelligibility at the early stage after hearing aid fitting in children with moderate or severe hearing loss

Objective：The aim of this study is to evaluate the development of auditory performance and speech intelligibility within the first year after hearing aid fitting in children with moderate or severe hearing loss, investi- gate the effects of hearing level on auditory performance and speech intelligibility and provide a clinical database for their hearing and speech habilitation. Method： Twenty-nine children participated in this study, ranging in age at hearing aid fitting from 3 to 8 years old with a mean of 5.6 years old. 19 were boys and 10 were girls. According to their hearing level, they were divided into two groups. 14 children were in group of moderate hearing loss（41-60 dB HI.）. 15 children were in group of severe hearing loss（61-80 dB HL）. The categories of auditory perform- ance（CAP）and speech intelligibility rating（SIR）were used to evaluate their auditory performance and speech intel- ligibility. The evaluation was performed before hearing aid fitting and 1, 3, 6, 9, 12 months after fitting. Result： There was significant difference in mean score of CAP between group of moderate hearing loss and severe hear-ing loss before hearing aid fitting（P~0.05）. However, no significant differences were observed between these two groups at 1, 3, 6, 9, 12 months after fitting（P~0.05）. There was also significant difference in mean score of SIR between group of moderate hearing loss and severe hearing loss before hearing aid fitting（P〈0.05）. How- ever, no significant differences were also observed between these two groups at 1, 3, 6, 9, 12 months after fitting （P〈0.05）. The mean scores of CAP for group of moderate hearing loss at 6, 9, 12 months after fitting were sig- nificantly superior in comparison with the score before hearing aid fitting（P〈0.05）. The mean scores of SIR for group of moderate hearing loss at 6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting（P〈0.05） ; the mean score at 12 months after fitting was also significantly superior in comparison with the score at 1 month after fitting（P〈0. 05）. The mean scores of CAP for group of severe hearing loss at 3, 6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting（P〈0.05） ; the mean scores at 9,12 months after fitting were significantly superior in compari- son with the score at 1 month after fitting（P〈0.05）. The mean scores of SIR for group of severe hearing loss at 3,6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting （P〈0.05） ; the mean scores at 6,9, 12 months after fitting were also significantly superior in comparison with the score at 1 month after fitting （P〈0.05）. Conclusion： Auditory performance and speech intelligibility in children with moderate or severe hearing loss improved significantly within the first year after hearing aid fitting. The de- velopment followed different trajectory.