【摘要】：目的使用聽(tīng)覺(jué)行為分級(jí)標(biāo)準(zhǔn)(categories of auditory performance,CAP)、聽(tīng)力植入體使用兒童的家庭生活質(zhì)量(children using hearing implants quality of life,Cu HI Qol)和Nijmegen人工耳蝸植入量表(Nijmegen Cochlear Implant Questionnaire,NCIQ)對(duì)語(yǔ)前聾青少年患者進(jìn)行問(wèn)卷調(diào)查,從而評(píng)估患者人工耳蝸植入術(shù)后聽(tīng)力、家庭及個(gè)人的生活質(zhì)量有無(wú)變化,并比較術(shù)前交流方式對(duì)術(shù)后康復(fù)效果有無(wú)影響。方法選取2010.07-2014.07期間在安徽醫(yī)科大學(xué)第一附屬醫(yī)院進(jìn)行耳蝸植入的14歲-18歲的青少年語(yǔ)前聾患者,并除外存在內(nèi)耳嚴(yán)重畸形、腦白質(zhì)病變及聽(tīng)神經(jīng)病的部分病人,共有41例,對(duì)這41例青少年患者的臨床資料進(jìn)行回顧性分析,并與植入術(shù)后兩年的康復(fù)效果進(jìn)行比較。按照術(shù)前交流方式(手勢(shì),唇讀,手勢(shì)-言語(yǔ),語(yǔ)言)將其分為非言語(yǔ)組(包括手勢(shì)與唇讀)和言語(yǔ)組(手勢(shì)-言語(yǔ)及語(yǔ)言交流),其中非言語(yǔ)組20例,言語(yǔ)組21例。采用CAP和Cu HI Qol量表分別于耳蝸植入術(shù)前及術(shù)后對(duì)患者家長(zhǎng)進(jìn)行問(wèn)卷調(diào)查,比較術(shù)前與術(shù)后得分的差異,用NCIQ量表于耳蝸植入術(shù)后對(duì)患者本人進(jìn)行問(wèn)卷調(diào)查,并分別比較非言語(yǔ)組及言語(yǔ)組患者術(shù)后Cu HI Qol和NCIQ得分有無(wú)不同。結(jié)果1.言語(yǔ)組和非言語(yǔ)組患者術(shù)后的CAP得分均較術(shù)前有明顯提高(p0.001)。2.完成Cu HI Qol問(wèn)卷的21例患者術(shù)后的Cu HI Qol得分(51.71±8.9)較術(shù)前有明顯提高(42.14±6.04,P0.001),而且在父母期望,對(duì)家庭的影響及個(gè)人生活質(zhì)量這三個(gè)亞方面術(shù)后得分均較術(shù)前有明顯提高(p=0.002,P0.001,P0.001)。對(duì)于兩組患者之間的比較,其中對(duì)家庭的影響方面言語(yǔ)組的術(shù)后得分與非言語(yǔ)組沒(méi)有明顯差異(p=0.7),父母的期望及生活質(zhì)量?jī)煞矫嫜哉Z(yǔ)組得分均高于非言語(yǔ)組(P=0.005,p0.001)。3.非言語(yǔ)組術(shù)后NCIQ平均得分為31.54±5.55,言語(yǔ)組平均得分為51.04±10.51,明顯高于非言語(yǔ)組(p0.001)。在高級(jí)聲音感知、言語(yǔ)能力和社會(huì)交流方面言語(yǔ)組的得分高于非言語(yǔ)組(P0.05),在基本聲音感知、自信心及活動(dòng)能力方面沒(méi)有明顯差異(p0.05)。結(jié)論青少年語(yǔ)前聾的患者人工耳蝸植入術(shù)后聽(tīng)力有明顯改善,患者家庭的生活質(zhì)量以及個(gè)人的生活質(zhì)量也有明顯提高,術(shù)前的交流方式可影響術(shù)后的康復(fù)效果,術(shù)前使用言語(yǔ)交流的患者術(shù)后可以獲得更好的生活質(zhì)量。
[Abstract]:Objective to evaluate the family quality of life (children using hearing implants quality of life,Cu HI Qol) and Nijmegen cochlear implant scale (Nijmegen Cochlear Implant Questionnaire,) in children with hearing implants using auditory behavioral grading standard (categories of auditory performance,CAP). (NCIQ) to evaluate the changes of hearing, family and personal quality of life after cochlear implantation in adolescents with prelingual deafness, and to compare the effect of preoperative communication on postoperative rehabilitation. Methods A total of 14 ~ 18 years old patients with prelingual deafness were enrolled in the first affiliated Hospital of Anhui Medical University from 2010.07-2014.07, with the exception of some patients with severe deformity of the inner ear, white matter lesions and auditory neuropathy. The clinical data of 41 adolescent patients were analyzed retrospectively and compared with the two years after implantation. They were divided into nonverbal group (including gesture and lip reading) and speech group (gesture-speech and verbal communication) according to the preoperative communication mode (gesture, lip reading, gesture-speech, language), including 20 cases in non-verbal group and 21 cases in speech group. Before and after cochlear implantation, CAP and Cu HI Qol were used to investigate the patients' parents, and the difference of scores before and after cochlear implantation was compared. NCIQ scale was used to investigate the patients themselves after cochlear implantation. The scores of Cu HI Qol and NCIQ in non-verbal group and speech group were compared. Result 1. The CAP scores in speech group and non-verbal group were significantly higher than those before operation (p 0. 001). 2. The Cu HI Qol scores of 21 patients who completed Cu HI Qol questionnaire (51.71 鹵8.9) were significantly higher than those before operation (42.14 鹵6.04 鹵P0.001). The effect on family and quality of personal life were significantly higher than those before operation (P 0.002 P 0.001). For the comparison between the two groups, there was no significant difference in the postoperative scores between the speech group and the non-verbal group (p0.7), and the scores of the parents' expectation and quality of life in the speech group were higher than those in the non-verbal group (P0.005). P0.001). The average score of NCIQ was 31.54 鹵5.55 in the nonverbal group and 51.04 鹵10.51 in the speech group, which was significantly higher than that in the non-verbal group (p0.001). The scores of speech group in advanced voice perception, speech ability and social communication were higher than those in non-verbal group (P0.05), but there was no significant difference in basic sound perception, self-confidence and activity ability (p0.05). Conclusion after cochlear implantation, the hearing of young patients with pre-speech deafness was improved significantly, and the quality of life and personal quality of life of the patients were also improved. The way of communication before and after operation may affect the rehabilitation effect after operation. Patients who use verbal communication before operation can obtain better quality of life after operation.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R764.9

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