儿童听力障碍现状分析与听力康复

【作者】 李晓璐；

【导师】 励建安； 卜行宽；

【作者基本信息】 南京医科大学 ， 康复医学和理疗学， 2007， 博士

【摘要】 “儿童听力障碍现状分析与听力康复”全文共分为三章，分别就儿童听力障碍的大规模人群调查、听力损失康复策略分析和人工耳蜗术后调试新技术在听力康复中的运用等方面探讨儿童听力障碍的现状和听力康复问题。本文主要有以下创新点：1．通过江苏省第二次全国残疾人抽样调查获得的第一手资料，分析本次调查样本中0-6岁儿童听力残疾的患病率、等级、预防现状和主要致残原因，反映了儿童听力残疾发生和发展的最新动态。2．证明自动听性脑干反应(automatic auditory brainstem response，AABR)可作为新生儿听力筛查的首选方法。3．根据江苏省第二次全国残疾人抽样调查数据，对本省0-6岁儿童的康复策略及康复需求作出最新分析。建议(1)建立社会保障机制，保证家庭贫困的重度听力残疾儿童能够享有必需的医疗和康复服务。(2)开办“听障儿童家长学习班”，开展低龄听障儿童的早期康复。(3)重视广大农村地区听力残疾儿童的康复问题。4．和澳大利亚University of Queensland听力学系合作，积极探索适合我国国情的学龄儿童听力筛查方法，特别是适用于中国广大农村地区听力筛查方法，加强农村学龄儿童听力障碍的防治。5．探讨人工耳蜗植入(cochlear implants，CI)术后，主观心理物理测试(T值和C值)的均值与客观电诱发听神经复合动作电位(electrically evoked compound action potentials，ECAP)阈值之间的相关性。回归方程分别为：T=0.83NRT阈值+0.57(R~2=0.9052，P=0.0128)，C=59.83+0.75NRT阈值(R~2=0.9796，P=0.0103)。应用本研究成果可以辅助语前聋儿CI术后调机(mapping)，依照ECAP阈值来设定T、C值，提高调试的准确度，有利于开机初期的听觉培建。更多还原

【Abstract】 "The hearing impairment status analysis and hearing rehabilitationon children" is composed of 3 parts: the sampling survey of hearingimpairment, the analysis of rehabilitation strategy and the new technologyin mapping after cochlear implants in prelingually deafness youngchildren. There are several highlights:1. According to the first-hand database from the China secondsampling disability survey (Jiangsu province) in 2006, the prevalence,grade, and pathogenesis of hearing disability on 0-6 year old childrenwere analysised. The results reflect the new trends on the prevalence anddevelopments of hearing disability in the new era.2. To confirm that automatic auditory brainstem response (AABR)can be used as the first choice in the universal neonatal hearing screening.3. To investigate the rehabilitation demands and strategy of 0-6 yearsold children with hearing disability in Jiangsu province. The results show:(1) The low income families with severe hearing loss children need morespecial policy to help them in expensive medical service such as cochlearimplants. (2) The rehabilitation demands of less than 3 years old childrenand rural areas should be taken into account.4. Under the support from University of Queensland, Australia, triedto develop an appropriate mass screening system to evaluate hearing loss for primary school children, especially in rural areas.5. To investigate the relationship of electrically evoked compoundaction potentials (ECAP) to psychophysical performance. Linearregression analysis showed both the average of T-level and C-level hadgood correlation with ECAP threshold. The linear regression formula is:T=0.83NRT threshold +0.57 (R~2=0.9052, P=0.0128), C=59.83+0.75NRTthreshold (R~2=0.9796, P=0.0103). It is useful in predicting mapping aftercochlear implants on young prelingually deaf children, who could notdemonstrate reliable psychophysical performance.更多还原