听神经病儿童人工耳蜗术后长期听觉言语康复效果研究

张李芳; 孟超; 郭倩倩; 孔颖; 吕静; 董瑞娟; 李玉玲; 亓贝尔; 王硕; 陈婧媛; 魏兴梅; 陆思萌; 薛书锦; 高振橙; 陈雪清; 李永新

doi:10.3969/j.issn.1672-4933.2025.03.006

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听神经病儿童人工耳蜗术后长期听觉言语康复效果研究

听障儿童听觉言语能力发育规律评估 | 更新时间：2026-07-11

- 听神经病儿童人工耳蜗术后长期听觉言语康复效果研究
- Long-term Auditory and Speech Rehabilitation Effects after Cochlear Implantation in Children with Auditory Neuropathy
- 中国听力语言康复科学杂志 2025年23卷第3期页码：245-250
- 作者机构：
  
  1.民政职业大学康复工程学院北京 102600
  2.首都医科大学附属北京同仁医院/北京市耳鼻咽喉科研究所/耳鼻咽喉头颈外科学教育部重点实验室（首都医科大学）北京 100730
  3.首都医科大学附属北京同仁医院耳鼻咽喉头颈外科北京 100730
- 作者简介：
  
  张李芳医学博士讲师；研究方向：耳科学与听力学
  李永新，E-mail： entlyx@sina.com
- 基金信息：
  
  国家自然科学基金项目(81670923);国家重点研发计划(2022YFC2402705);中央高校基本科研业务费资助项目(JBKYKJCX2024-7)
- DOI：10.3969/j.issn.1672-4933.2025.03.006
  中图分类号： R767.92
- 收稿：2025-04-13，
  
  纸质出版：2025-05-15
- 稿件说明：
移动端阅览
张李芳,孟超,郭倩倩等.听神经病儿童人工耳蜗术后长期听觉言语康复效果研究[J].中国听力语言康复科学杂志,2025,23(03):245-250.

ZHANG Li-fang,MENG Chao,GUO Qian-qian,et al.Long-term Auditory and Speech Rehabilitation Effects after Cochlear Implantation in Children with Auditory Neuropathy[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2025,23(03):245-250.
张李芳,孟超,郭倩倩等.听神经病儿童人工耳蜗术后长期听觉言语康复效果研究[J].中国听力语言康复科学杂志,2025,23(03):245-250. DOI： 10.3969/j.issn.1672-4933.2025.03.006.

ZHANG Li-fang,MENG Chao,GUO Qian-qian,et al.Long-term Auditory and Speech Rehabilitation Effects after Cochlear Implantation in Children with Auditory Neuropathy[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2025,23(03):245-250. DOI： 10.3969/j.issn.1672-4933.2025.03.006.

摘要

目的

探讨听神经病（auditory neuropathy，AN）儿童人工耳蜗植入（CI）术后5年内听觉和言语康复效果。

方法

纳入89例内耳结构正常的单侧CI语前聋患儿，根据听力诊断分为AN组（34例）和普通重度或极重度感音神经性听力损失（sensorineural hearing loss，SNHL）对照组（55例）。由经过统一规范化培训的专业人员采用听觉行为分级标准量表（CAP）、言语可懂度分级标准量表（SIR）评估听觉言语康复效果。评估时间点为术前及开机后1、3、6、12、18、24、36、48、60个月。

结果

AN组患儿CAP得分在开机后6、12、24、36个月时均显著低于对照组（

0.05），在术前、开机1、3、18、48、60个月时无显著差异（

0.05）。AN组SIR得分仅在开机18个月时显著低于对照组（

0.05），其余各随访时间两组无显著差异（

0.05）。AN组患儿CAP得分在术前与开机1个月、开机1个月与3个月、开机6个月与12个月间有显著差异（

0.05），而在开机1年后，各相邻随访时间点间无显著差异（

0.05）。对于非相邻随访时间点间的比较，开机3年与4年间无显著差异（

0.05）。AN组SIR得分在开机6个月与12个月、开机18个月与24个月间有显著差异（

0.05），其余各相邻随访时间点SIR无显著差异（

0.05）。对于非相邻随访时间点的比较，开机1个月与6个月、开机18、24、36、48、60个月内各随访时间点间的差异均无统计学意义（

0.05）。

结论

CI可有效改善AN患儿的听觉能力和言语能力，且其远期听觉言语康复效果与非AN的普通SNHL患儿相近。AN患儿CI术后听觉能力在开机1年内快速提升，后期增长趋势减缓；言语可懂度在术后0.5～2年内快速增长，后期增长趋势减缓。

Abstract

Objective

To investigate the auditory and speech rehabilitation outcomes in children with auditory neuropathy (AN) within 5 years after cochlear implantation (CI).

Methods

A total of 89 unilateral CI children with prelingual deafness who had normal inner ear structures were included in this study

and they were divided into the AN group (34 cases) and the control group (55 cases) with ordinary severe or very severe sensorineural hearing loss (SNHL) according to the diagnosis of audiology. Auditory and speech rehabilitation outcomes were assessed by the same group of uniformly standardized trained professionals using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) standard scales. The assessment time points were preoperative and 1

and 60 months after CI.

Results

The CAP scores of the children in the AN group were significantly lower than those of the control group at 6

and 36 months after switch-on (

0.05)

and the differences between the two groups were not statistically significant at preoperative

and 1

and 60 months after switch-on (

0.05). Their SIR scores were significantly lower than those of the control group only at 18 months after switch-on (

0.05)

and there was no statistically significant difference between the two groups at the rest of the follow-up time points (

0.05). The differences in the CAP scores of the AN group were significant (

0.05) between the preoperative period and 1 month after switch-on

1 month after switch-on and 3 months after switch-on

and 6 months after switch-on and 12 months after switch-on

whereas the differences in the CAP scores between the adjacent follow-up time points after 1 year of switch-on were not statistically significant (

0.05)

and for the comparisons betw

een the non-adjacent follow-up time points

there was no statistically significant difference between the 3-year after switch-on and the 4-year after switch-on (

0.05). The differences in their SIR scores between 6 months after switch-on and 12 months after switch-on

and between 18 months after switch-on and 24 months after switch-on were significant (

0.05)

and there were no statistically significant differences between the rest of the adjacent follow-up time points (

0.05)

and for the comparisons between the non-adjacent follow-up time points

the differences between 1 month after switch-on and 6 months after switch-on

as well as between 18

and 60 months the differences between follow-up time points were not statistically significant (

0.05).

Conclusion

CI can effectively improve the auditory and speech abilities of AN children and its long-term auditory- speech rehabilitation effect is similar to that of non-AN regular SNHL. The postoperative auditory ability of children with AN after CI increased rapidly within 1 year after CI

and then slowed down in the later period; the speech intelligibility increased rapidly within 6 months to 2 years after CI

and then slowed down in the later period.

关键词

Keywords

references

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