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甲状腺切除术后患者嗓音声学分析动态观察

Voice Acoustic Analysis in Parients Underwent Thyroidectomy

王英俊;华辉;葛瑞锋;孙彦;

1:山东大学附属省立医院耳鼻咽喉头颈外科山东省立医院集团眼耳鼻喉医院耳鼻咽喉头颈外科

2:青岛大学附属医院耳鼻咽喉头颈外科

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摘要

目的动态分析甲状腺切除术后患者的嗓音变化,探讨该手术对患者发声功能的影响。方法甲状腺切除术患者48例(实验组,甲状腺腺叶及峡部切除术34例、甲状腺全切术14例)、颈部非甲状腺手术患者19例(对照组)于术前1天、术后1、2、3、7、30天分别行电子喉镜检查及嗓音声学分析,分析两组嗓音基频(F0)、基频标准差(F0TD)、基频微扰(jitter)、振幅微扰(shimmer)及信噪比(HNR)的动态变化特点。结果实验组和对照组术前、术后无声带麻痹和环杓关节脱位。实验组男性患者术后1天F0TD值高于术前1天及术后30天(P<0.05);女性患者术后1天F0值显著低于术前1天和术后2、7、30天(P<0.05),术后30天jitter值显著低于术后1天,术后1、2、3、7天F0TD值较术前显著升高,术后30天F0TD值较术后1天显著降低,术后30天HNR值较术后3天显著降低(P<0.05)。实验组男性患者手术前后各嗓音声学分析指标与对照组比较差异无统计学意义(P>0.05);实验组女性患者术前、术后1、2、3、7天F0值较对照组显著降低,术后1天jitter值、shimmer值较对照组显著升高,HNR值较对照组降低(均为P<0.05),但术后30天各项指标均与对照组女性差异无统计学意义(P>0.05)。结论无喉返神经损伤的甲状腺切除术后患者存在一定程度的嗓音声学分析指标异常,以女性患者明显,术后第30天开始好转。

关键词

甲状腺手术;嗓音;声学分析;声学参数

基金项目(Foundation):

作者

王英俊;华辉;葛瑞锋;孙彦;

参考文献

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王英俊华辉葛瑞锋孙彦