目的：通过对129例极重度语前聋患者人工耳蜗植入术后声母、韵母、单音节及双音节词识别能力的评估，研究人工耳蜗植入术后患者的听觉康复效果及相关影响因素。方法选用《听力障碍儿童听觉、语言能力评估标准及方法》作为测试材料，分别测试患者的声母、韵母、单音节词、双音节词识别率，用各分项评估结果的均值代表总体听觉能力，进而研究康复时间、植入年龄、术前配戴助听器经验及性别对听觉能力的影响。结果随着康复时间的延长，听觉能力各分项得分逐渐提高（P<0.05）。术前、术后6个月及术后1年低龄组与大龄组间总体听觉能力差异有统计学意义（P<0.05），术后3个月两组间差异无统计学意义（P>0.05）。人工耳蜗植入术前、术后3个月、6个月及1年，男、女组之间总体听觉能力差异无统计学意义（P>0.05），配戴助听器组与未配戴助听器组间总体听觉能力差异无统计学意义（P>0.05）。结论人工耳蜗植入能提高语前聋患者的听觉能力。植入时间越长，听觉康复效果越好；植入时年龄越小，术后听觉能力进步越快。大龄语前聋患者植入人工耳蜗后听觉能力仍能获得一定的改善。术前短时间配戴助听器对于极重度语前聋患者术后听觉能力康复无明显帮助。%Objective To assess the consonant, vowel, monosyllable and bisyllable recognition abilities of 129 prelingually profound hearing-impaired children and to study the influential factors on the auditory rehabilitation outcomes after cochlear implantation. Methods The Criteria and Method for Evaluation of Auditory and Speech Abilities of Hearing-impaired Children was used to test the consonant, vowel, monosyllable and bisyllable recognition scores of the children. The average score of the 4 tests was used to represent the auditory abilities. The influences of rehabilitation time, implantation age, hearing aids and gender on auditory abilities were studied. Results The recognition scores increased significantly as time went by (P<0.05). There were significant differences in the average score between the implantation age younger than 7 years old and older than 7 years old group before cochlear implantation and 6 months and 1 year after cochlear implantation(P<0.05),but no significant difference 3 months after cochlear implantation(P>0.05). There was no significant difference in the average score between males and females (P>0.05) as well as between groups with and without hearing aid experience(P>0.05) before cochlear implantation and 3,6,12 months after cochlear implantation.Conclusion Cochlear implants can enhance the auditory abilities of prelingually hearing-impaired children, and the rehabilitation outcomes tend to improve as time goes on. The children who receive cochlear implantation at an early age will achieve faster progress, but the children older than 7 years old at cochlear implantation can also get an improvement. Short-time hearing aid use has no significant influence on the auditory rehabilitation outcome of prelingually profound hearing-impaired patients.
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