影响语前聋青少年人工耳蜗术后疗效因素的探讨

目的探讨语前聋青少年人工耳蜗植入技术(CI)患者获得效益情况和影响因素,为患者术前选择、咨询和术后评价方式提供资料。方法30例语前聋青少年CI患者和家庭接受“CI满意度问卷”调查,其中19例患者参加言语测试。结果术前佩戴过助听器组与未戴助听器对CI的总体满意度分别为3.93±0.88和3.00±1.13,两组间差异有统计学意义(P<0.05)且会影响术后患者言语发育;术前口语唇读组与手语组交流方式之间,术后两组7项言语测试结果分别为74、60、64、61、57、43、27和43、39、26、26、19、6、5两组间差异有统计学意义(P<0.01),前组能力改善显著。CI术前期望值与术后满意度呈负相关关系(γ=-0.479,P<0.05)。结论接受CI植入的语前聋青少年患者可从中获得较大效益,但应根据患者需求建立特有的评价系统。

Analysis of factors effecting satisfaction of cochlear implants in prelingually deafened adolescents

OBJECTIVE: By means of investigating how the benefit and the influence factors are for the pre-lingual deaf adolescents who received cochlear implantation (CI) METHODS: A questionnaire survey was conducted among 30 prelingually deaf adolescents-cochlear implant recipients, aged 9 approximately 20, 15 of which began to use hearing aid before the age of 6, and 19 of which had received speech testing after the CI, and their families to understand the degree of satisfaction, anticipation of the outcome. Nine of the 15 patients who began to use hearing aid before the age of 6 communicated by the oral communication/labial reading model (oral group), and 10 of the other 15 patients who had not used hearing aid after the age of 6 mainly communicated by sign language (sign group). RESULTS: The satisfaction score of the group with a hearing aid fitting history was 3.93 +/- 0.88, significantly higher than that of the group without a hearing aid fitting history (3.00 +/- 1.13, P < 0.05). The scores of speech production ability in vowel, consonant, single syllable, disyllable, trisyllable, and short sentence in the groups with and without a hearing aid fitting history were 76%/52%, 64%/45%, 71%/26%, 82%/96%, 68%/12%, and 49%/13% respectively (all P < 0.05), and there was no significant difference in the speech production ability in tone (P > 0.05) between these 2 groups. There were no significant differences in the total satisfaction degree, satisfaction degree in speech sound, and satisfaction degree in environmental sound between the oral group and sign group (all P > 0.05). The scores in vowel, consonant, single syllable, disyllable, trisyllable, short sentence, and tone of the oral and sign group were 74%, 60%, 64%, 61%, 57%, 43%, 27% and 43%, 39%, 26%, 26%, 20%, 6%, 5% respectively (all P > 0.01). The anticipation of the patient and the parents about outcome before implantation was negatively correlated with the satisfaction degree after implantation, (gamma = -0.479, P < 0.05). CONCLUSION: Cochlear implantation benefits greatly the deaf adolescent; however, it is necessary to establish a specific evaluation system according to recipients' needs.