CAJ | 학술논문

目的：总结成人语后聋患者人工耳蜗植入术后的声音察觉及言语感知，探讨成人重获听力的期望值，是否需要进行听力训练及适应交往时间。方法选取2002-2011年成人语后聋人工耳蜗植入术后患者16例，其中9例患者开机即参与训练，1例开机后3个月内在自然环境等待自然康复，无效果而来训练，6例患者一直未参与训练。参与训练者起始在自然的环境中给予乐音、语音不同频率声音的输入测试听力，听力训练每日2 h，单训及合训结合。以听觉言语感知、书写及言语表达等多种综合沟通形式并用，进行为期3～10周的听觉培建。从听觉培建后期开始增加言语训练，注重口语朗读的连贯性及清晰度，考察音义结合及回归适应社会的效果。结果参与训练的10例中，4例耳蜗植入术后开机即刻训练达5周以上，1例间断训练4周，5例短暂（最短3～4 d）训练。6例不参与训练。参与训练大于4周的5例患者《最低听觉功能测试词表》测试总辨别率平均为90．3％，5～7个月逐步适应工作及学习环境，1．5～2．0年可正常交流；短期训练的5例中经《最低听觉功能测试词表》测试3例总辨别率平均为36．0％；2例不能完成测试；未参与训练的6例患者平均术后2年均不能完成测试。结论人工耳蜗植入使语后聋成人获得了重获听力的基础，术后训练使患者重获听力成为现实，训练时间短于语前聋小儿，但仍需到达一定时间。
목적：총결성인어후롱환자인공이와식입술후적성음찰각급언어감지，탐토성인중획은력적기망치，시부수요진행은력훈련급괄응교왕시간。방법선취2002-2011년성인어후롱인공이와식입술후환자16례，기중9례환자개궤즉삼여훈련，1례개궤후3개월내재자연배경등대자연강복，무효과이래훈련，6례환자일직미삼여훈련。삼여훈련자기시재자연적배경중급여악음、어음불동빈솔성음적수입측시은력，은력훈련매일2 h，단훈급합훈결합。이은각언어감지、서사급언어표체등다충종합구통형식병용，진행위기3～10주적은각배건。종은각배건후기개시증가언어훈련，주중구어랑독적련관성급청석도，고찰음의결합급회귀괄응사회적효과。결과삼여훈련적10례중，4례이와식입술후개궤즉각훈련체5주이상，1례간단훈련4주，5례단잠（최단3～4 d）훈련。6례불삼여훈련。삼여훈련대우4주적5례환자《최저은각공능측시사표》측시총변별솔평균위90．3％，5～7개월축보괄응공작급학습배경，1．5～2．0년가정상교류；단기훈련적5례중경《최저은각공능측시사표》측시3례총변별솔평균위36．0％；2례불능완성측시；미삼여훈련적6례환자평균술후2년균불능완성측시。결론인공이와식입사어후롱성인획득료중획은력적기출，술후훈련사환자중획은력성위현실，훈련시간단우어전롱소인，단잉수도체일정시간。
Objective To analysis the re-hearing expectations and the need for auditory training and the time of adaptation exchanges after cochlear implantation .Methods Sixteen cases of adult postlingual deafness, which were selected, from 2002 to 2011, were treated by cochlear implantation .9 cases participated in speech training right after cochlear implantation , and 7 cases didn ’ t participate in speech training .In the initial stage, the patients were given the tone and input hearing test with voice frequency in the natural environment.The auditory training was for 2 hours a day, which included single and combined training .The training method was comprehensive , including auditory speech perception , writing and verbal expression .The training focused on the coherence and clarity of oral Reading .One training course was 3 -10 weeks .The efficacy of the training with the combination of sound and the ability to adapt to society was analyzed . Results In 10 cases joining the training , 4 cases instantly began to auditory training after cochlear implantation and lasted for more than 5 weeks.1 case discontinuously trained for 4 weeks, and other 5 cases trained transiently ( less than 3 ~4 days ) .6 cases refused to participate in the training process after cochlear implantation .Assessed by the “the lowest auditory function test vocabulary”, the distinguish rate of 5 patients was 90.3%after training for more than 4 weeks, who gradually adapted to working and learning environment after 5-7 months, and gained normal communication after 1.5-2.0 years.The distinguish rate of 5 patients was 36.0%after training for several days , and 2 patients cannot accomplish the test .Besides, the 6 patients without participation the training program cannot finish the assessment for over 2 years after cochlear implantation.Conclusions Cochlear implantation provides patients with the possibility of re-hearing, and the postoperative training can help patients in communicating in social life .A variety of factors can affect the efficacy of re-hearing adult patients with post-lingual hearing after cochlear implantation .