CAJ | 학술논문

目的：利用电诱发中潜伏期反应（Electrically evoked middle latency response，EMLR）对语前聋人工耳蜗植入患儿进行听觉功能评估，了解人工耳蜗植入年龄对听觉功能的影响，研究语前聋患儿人工耳蜗植入后听觉功能的变化规律。为人工耳蜗植入时间的选择及植入后听觉康复训练计划的制定提供理论依据。方法本研究共有42例语前聋患儿参与，按植入年龄将患儿分为2组，植入年龄小于3岁的患儿28例，大于3岁的患儿14例，平均植入后时间为（15.06±15.53）月。按人工耳蜗植入后时间将患儿分为4组，植入后小于6个月的患儿12例，6～12个月的患儿16例，12～24个月的患儿4例，大于24个月的患儿10例，平均植入年龄为（2.98±1.64）岁。分别对各组病人进行EMLR的检测，并对结果进行统计分析。结果42例语前聋人工耳蜗植入患儿中共有38例检出EMLR，总检出率为90.48%。3岁以内进行人工耳蜗植入患儿的PaNb平均波间振幅（2.34±1.26）μV，3岁以后进行植入患儿的平均PaNb波间振幅（1.48±0.49）μV，两组间存在显著差异，p<0.05。人工耳蜗植入后6～12个月患儿的Pa波潜伏期为（30.52±0.85）ms，人工耳蜗植入后24个月以上患儿的Pa波潜伏期为（25.98±1.80）ms，两组间存在显著差异，p<0.05。结论植入年龄和植入后时间是语前聋儿童人工耳蜗植入后听觉功能的重要影响因素。语前聋患儿3岁以内植入人工耳蜗患儿的听觉功能明显优于3岁以上植入的患儿。语前聋患儿的听觉功能在人工耳蜗植入后的两年内处于快速变化期，此时期内进行康复训练患儿可获得较好的听觉功能。
목적：이용전유발중잠복기반응（Electrically evoked middle latency response，EMLR）대어전롱인공이와식입환인진행은각공능평고，료해인공이와식입년령대은각공능적영향，연구어전롱환인인공이와식입후은각공능적변화규률。위인공이와식입시간적선택급식입후은각강복훈련계화적제정제공이론의거。방법본연구공유42례어전롱환인삼여，안식입년령장환인분위2조，식입년령소우3세적환인28례，대우3세적환인14례，평균식입후시간위（15.06±15.53）월。안인공이와식입후시간장환인분위4조，식입후소우6개월적환인12례，6～12개월적환인16례，12～24개월적환인4례，대우24개월적환인10례，평균식입년령위（2.98±1.64）세。분별대각조병인진행EMLR적검측，병대결과진행통계분석。결과42례어전롱인공이와식입환인중공유38례검출EMLR，총검출솔위90.48%。3세이내진행인공이와식입환인적PaNb평균파간진폭（2.34±1.26）μV，3세이후진행식입환인적평균PaNb파간진폭（1.48±0.49）μV，량조간존재현저차이，p<0.05。인공이와식입후6～12개월환인적Pa파잠복기위（30.52±0.85）ms，인공이와식입후24개월이상환인적Pa파잠복기위（25.98±1.80）ms，량조간존재현저차이，p<0.05。결론식입년령화식입후시간시어전롱인동인공이와식입후은각공능적중요영향인소。어전롱환인3세이내식입인공이와환인적은각공능명현우우3세이상식입적환인。어전롱환인적은각공능재인공이와식입후적량년내처우쾌속변화기，차시기내진행강복훈련환인가획득교호적은각공능。
Objective This research, using electrically evoked middle latency responses (EMLR) as a measure of auditory performance, aimed to investigate the effect of age at cochlear implant on auditory perfor-mance and to study dynamic changes in auditory performance after cochlear implant, in the hope of providing theoretical foundation for guiding future cochlear implantation and rehabilitation training. Methods There were 42 prelingual deafness children included in this research, divided into 2 groups by age at cochlear im-plant, i.e. before 3 years (n=28) or after (n=14) (mean=2.98±1.64 years);and into 4 groups by duration of implant use, i.e. less than 6 months (n=12), 6 to 12 months (n=16), 12 to 24 months (n=4) and more than 24 months (n=10) (mean=15.06±15.53 months). EMLRs were tested and results analyzed for each group. Result EMLRs were induced in 38 of the 42 children (90.48%). The PaNb amplitude was 2.34 ± 1.26μV in children who received implants before 3 years of age, and 1.48 ± 0.49 μV in those implanted after 3 years of age (p<0.05). Pa latency was 30.52±0.85 ms in children who had used cochlear implant for 6 to 12 months, and 25.98± 1.80 ms in those who had used implant for more than 24 months (p<0.05). Conclusion The age at cochlear im-plant and the duration after cochlear implantation affect auditory performance in children with prelingual deaf-ness, which appears to be bettern in those implanted before 3 years of age than after. Auditory performance ap-pears to rapidly improve in the first 2 years after implantation, suggesting that rehabilitation training in the first 2 years after cochlear implant is very important.