老年患者人工耳蜗植入术后听觉言语能力和生活质量评估

Assessment of Auditory Performance, Speech Intelligibility and Quality of Life after Cochlear Implantation in Elderly Patients

摘要: 目的：本研究采用听觉行为分级标准(Categories of Auditory Performance, CAP)、言语可懂度分级标准(Speech Intelligibility Rating, SIR)及Nijmegen人工耳蜗植入量表(Nijmegen Cochlear Implant Questionnaire, NCIQ)，对老年人工耳蜗植入患者术前及术后6个月的听觉行为表现、言语识别与可懂度水平及生活质量进行系统量化分级评估，为优化老年人工耳蜗植入患者术后康复策略、提高临床干预效果及患者长期生活质量改善提供科学依据。方法：选取40例年龄大于60岁的人工耳蜗植入患者，分别在人工耳蜗植入术前及术后6个月时，采用CAP表和SIR表对患者进行听觉行为和言语识别能力进行分级，并应用NCIQ进行生活质量的评估，通过相关性分析明确患者生活质量评分分别与CAP评分(听觉功能指标)、SIR评分(言语功能指标)间的关联强度及方向，以及评估人工耳蜗植入术对老年患者生活质量的改善效果。结果：术后40例患者的生活质量均较术前显著改善。老年人工耳蜗植入患者术后的NCIQ总体得分均有所提高，差异有统计学意义(p < 0.01)；相关性分析显示，患者术前、术后生活质量与听觉言语显著正相关，(r > 0, p < 0.05)。结论：人工耳蜗植入手术在改善老年听力减退患者生活质量方面具有显著的有效性，且听觉行为及言语可懂度是影响生活质量的重要因素。

Abstract: Objective: This study used the Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Nijmegen Cochlear Implant Questionnaire (NCIQ) to systematically and quantitatively assess the auditory behavior, speech recognition and intelligibility levels, and quality of life of elderly cochlear implant patients before and 6 months after surgery. This provides a scientific basis for optimizing postoperative rehabilitation strategies for elderly cochlear implant patients, improving the effectiveness of clinical interventions, and enhancing patients’ long-term quality of life. Methods: Forty patients over 60 years of age who underwent cochlear implantation were selected. Auditory behavior and speech recognition abilities were assessed using the CAP and SIR scales before and 6 months post-implantation. The NCIQ was used to evaluate quality of life. Correlation analysis was conducted to clarify the strength and direction of the association between patients’ quality of life scores and CAP (auditory function index) and SIR (speech function index), and to evaluate the effect of cochlear implantation on improving the quality of life of elderly patients. Results: Post-surgical outcomes demonstrated a significant enhancement in the quality of life for all 40 enrolled patients. The overall NCIQ score of elderly patients with cochlear implants showed a statistically significant improvement after surgery (p < 0.01). The correlation analysis showed that the quality of life of patients postoperatively and preoperatively is significantly positively correlated with auditory performance and speech intelligibility (r > 0, p < 0.05). Conclusion: Cochlear implantation is an effective intervention that can significantly improve the quality of life of elderly patients with hearing impairment. Auditory behavior and speech intelligibility are identified as crucial determinants influencing the quality of life.