发声训练治疗声带小结的疗效分析

诸葛盼;尤慧华;王翰青;张玉兰;杜欢乐;

1:浙江省金华市中心医院耳鼻咽喉科

摘要

目的探讨发声训练对声带小结患者的疗效。方法对65例声带小结患者进行3个月的发声训练,治疗前后进行动态喉镜检查,以声带小结消失为治愈标准,应用中文版嗓音障碍指数量表(voice handicap index,VHI)评估患者治疗前后主观嗓音障碍,记录功能(F)、生理(P)、情感(E)得分并计算总分(T)。应用德国IXON公司的DiVAS嗓音软件分析治疗前后患者的最长发声时间(maximum phonation time,MPT)、基频微扰(jitter)、最高基频(highest frequency,F0-High)、最低音强(lowest intensity,I-Low),计算嗓音障碍严重指数(dysphonia severity index,DSI),评估患者治疗前后客观嗓音障碍程度。结果 65例声带小结患者中18例退出治疗,完成治疗的47例治疗前后声带振动幅度、对称性、周期性正常,9例治疗前声门闭合不全者治疗后7例声门闭合良好;47例中治愈26例(55.32%,26/47)。患者治疗前VHI评估F、P、E、T均值分别为9.66±7.05、17.60±9.26、8.06±8.55、34.04±22.91,治疗后分别为6.13±5.34、12.45±7.80、5.17±6.13、23.60±17.17,治疗后较治疗前改善(P<0.01)。治疗前MPT 16.66±3.56s、jitter 1.32%±0.68%、F0-High 395.98±49.26Hz、I-Low56.70±3.56dB、DSI 0.39±1.10,治疗后MPT 18.47±3.69s、jitter 1.09%±0.39%、F0-High 415.11±44.71Hz、I-Low 54.70±3.30dB、DSI 1.51±0.84,治疗后较治疗前改善(P<0.01)。结论发声训练对声带小结患者嗓音质量改善有一定作用。

关键词

声带小结;发声训练;嗓音障碍指数量表;嗓音障碍严重指数

基金项目(Foundation):

浙江省科技厅项目(2011C23129);; 金华市科技局重点项目(2011-3-009)

作者

诸葛盼;尤慧华;王翰青;张玉兰;杜欢乐;

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诸葛盼尤慧华王翰青张玉兰杜欢乐