人工耳蜗植入术在语前聋患者中的应用：听力、言语能力和生活质量评估。
Cochlear implantation in prelingually deafened patients: Evaluation in hearing, speech ability, and quality of life.
机构信息
Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha 410011.
Xiangya Nursing School, Central South University, Changsha 410013, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021;46(9):989-995. doi: 10.11817/j.issn.1672-7347.2021.210336.
OBJECTIVES
The main purpose of cochlear implantation for prelingual deafness is to restore the deaf children's auditory function, obtain normal speech development, learning and social ability, and improve the quality of life. Previous studies mostly focused on the improvement of simple hearing or speech ability. This study aims to evaluate the changes of hearing and speech ability and family life quality of patients after cochlear implantation, and to explore the effect of cochlear implantation on hearing and speech rehabilitation of patients.
METHODS
In February 2021, using the convenient sampling method, 171 patients who have completed cochlear implantation were selected from the database of cochlear implantation follow-up center of a class III Tertiary hospital in Hunan Province. Questionnaires were used to investigate the patients' parents, which were Categories of Auditory Performance (CAP), Speech/Spatial and Qualities of Hearing Scale-Parents' Version (SSQ-P), and Children using Hearing Implants Quality of Life (CuHI-QoL). -test and analysis of variance were used to explore the postoperative auditory and speech ability of patients at different ages in different periods (<2.5-year group, 2.5-4.5-year group and >4.5-year group), and Pearson correlation analysis was used to explore the correlation. Multiple linear regression was used to explore the relationship between the dimension of patients' quality of life and the scores of scale for evaluating auditory ability (CAP, speech perception, spatial hearing, and other hearing characteristics).
RESULTS
The values of CAP and SSQ-P in the <2.5-year group were lower than those in the 2.5-4.5-year and >4.5-year groups (all <0.05). Pearson correlation analysis showed that postoperative years and CuHI-QoL scores (parental expectations and patients' quality of life) were positively correlated with score of CAP, SSQ-P and its dimension, respectively (all <0.05). The results of multiple linear regression analysis showed the CAP scores and speech perception were the influencing factors for the quality of life (=0.170, <0.01).
CONCLUSIONS
Two and a half years after operation is the rapid growth period of patients' hearing and language ability, and the growth rate becomes slow after stabilization. With the extension of postoperative years, the patients' hearing and speech ability becomes stronger, and the quality of life is better.
目的
语前聋患者进行人工耳蜗植入的主要目的是恢复聋儿的听觉功能，获得正常的言语发展、学习和社会能力，提高生活质量。以往的研究大多集中在简单的听力或言语能力的提高上。本研究旨在评估患者人工耳蜗植入后听力和言语能力以及家庭生活质量的变化，并探讨人工耳蜗植入对患者听力和言语康复的影响。
方法
2021 年 2 月，采用便利抽样法，从湖南省某三级甲等医院人工耳蜗植入随访中心数据库中选取 171 例已完成人工耳蜗植入的患者。采用问卷调查患者家长，量表包括听觉能力量表（CAP）、言语/空间和听觉质量量表-家长版（SSQ-P）、儿童使用人工耳蜗生活质量量表（CuHI-QoL）。采用 t 检验和方差分析比较不同时期（<2.5 岁组、2.5-4.5 岁组和>4.5 岁组）不同年龄患者术后听觉和言语能力的差异，采用 Pearson 相关分析探讨相关性。采用多元线性回归分析患者生活质量各维度与评估听觉能力量表（CAP、言语感知、空间听觉和其他听觉特征）得分的关系。
结果
<2.5 岁组 CAP 和 SSQ-P 得分均低于 2.5-4.5 岁组和>4.5 岁组（均<0.05）。Pearson 相关分析显示，术后时间与 CuHI-QoL 评分（家长期望和患者生活质量）与 CAP、SSQ-P 及其维度得分均呈正相关（均<0.05）。多元线性回归分析结果显示，CAP 得分和言语感知是生活质量的影响因素（β=0.170，<0.01）。
结论
术后 2.5 年是患者听觉和语言能力快速增长期，增长速度稳定后变慢。随着术后时间的延长，患者的听觉和言语能力增强，生活质量提高。
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