不同双侧干预模式患儿听觉效果及影响因素分析

Auditory outcomes and influencing factors by different bilateral intervention modes in children with cochlear implantation

刘佩;张标新;邱建新;孙琴枝;汪璐璐;张纯靖;崔圆圆;吴婷

1:安徽医科大学护理学院

2:安徽医科大学第一附属医院耳鼻咽喉头颈外科

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摘要

目的探讨不同双侧干预模式人工耳蜗植入患儿在安静和噪声环境下听觉效果及影响因素。方法 185例双侧重度-极重度感音神经性听力损失患儿按双侧干预模式分为：双模式组(BIM组)55例，双侧人工耳蜗同期植入组(SCI组)70例，双侧人工耳蜗序贯植入组(SBCI组)60例。采用儿童听力/口语评估家长问卷(PEACH量表)评估三组患儿双耳干预后1年在安静和噪声环境下的PEACH得分，分析植入年龄、术前残余听力、助听器佩戴情况、康复训练模式、家庭等相关因素对三组患儿安静和噪声环境下听觉效果的影响。结果 (1)三组患儿安静环境下PEACH得分均高于噪声环境下PEACH得分(P<0.05);(2)SCI组患儿安静和噪声环境下PEACH得分均高于BIM组，差异有统计学意义(P<0.05);(3)多因素分析显示，三组患儿安静或噪声环境下听觉效果的影响因素存在差异。3岁前首次植入、术前佩戴助听器、与家庭康复结合的训练模式是三组患儿安静和噪声下听觉效果共同的有利影响因素；术前平均残余听力(≤95 dB HL)是BIM组患儿安静环境下听能的有利影响因素；家长文化程度越高，SCI组和SBCI组患儿安静和噪声环境下听能获益越多；植入间隔时间≤24个月、植入间期佩戴助听器是SBCI组患儿噪声环境下听能的有利影响因素。结论重度-极重度语前聋患儿同期双侧CI术后在安静和噪声环境下的听觉表现优于双模式聆听。3岁前植入、术前或植入间期佩戴助听器可提高患儿噪声下听能，双侧序贯植入间隔宜在12个月以内。

关键词

双侧人工耳蜗植入;双模式;噪声;双耳听觉

基金项目(Foundation):

2023年度安徽医科大学护理学院研究生青苗培育项目(hlqm12023066);; 安徽医科大学自然科学基金项目(2020xkj156)

作者

刘佩;张标新;邱建新;孙琴枝;汪璐璐;张纯靖;崔圆圆;吴婷

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