首页 > 过刊浏览 > 文章详情

嗓音障碍疾病GRBAS听主观评估特点分析

Analysis of the Characteristics of GRBAS as the Subjective Auditory Assessment in Patients with Voicing Disorders

李红艳;徐文;胡蓉;胡慧英;侯丽珍;张丽;

1:首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈外科学教育部重点实验室

2:首都医科大学附属北京天坛医院耳鼻咽喉科

在线阅读

摘要

目的探讨嗓音障碍疾病GRBAS听主观评估特征。方法对1 780例嗓音障碍患者行GRBAS评估,包括:听主观总嘶哑度G、粗糙度R、气息度B、无力度A、紧张度S分级评估,根据疾病种类进行统计分析。结果声带接触性肉芽肿、慢性单纯性喉炎、声带角化、声带小结、痉挛性发声障碍G、R评估以轻度异常为主,B评估多为正常和轻度异常,除痉挛性发声障碍S评估异常者达85%外,余几种嗓音障碍疾病A、S评估异常者少见;声带息肉、声带囊肿、声带任克水肿G、R、B评估以轻、中度异常为主,A、S评估异常者少见;声带良性肿瘤、声门癌、病理性声带沟、单侧声带麻痹、功能性发声障碍G、B评估以重度异常为主,声带良性肿瘤、声门癌R评估以重度为主,病理性声带沟、单侧声带麻痹R评估中度异常为主,而功能性发声障碍各级比例相近,这几种疾病的嗓音A评估虽然仍以正常者居多,但异常者明显增加,达23%～47%,S评估除功能性发声障碍异常者多达50%,余未见异常。所有嗓音障碍疾病中,声带接触性肉芽肿在G、R、A、S评估中最轻,痉挛性发声障碍在B评估中最轻,声门癌在G、R评估中最重,单侧声带麻痹在B、A评估中最重,痉挛性发声障碍在S评估中最重。从R、B、A、S与G的相关性看,痉挛性发声障碍S与G显著相关(r=0.717),其他各嗓音疾病均为R、B与G显著相关(r=0.582～0.965),其中,声带接触性肉芽肿、慢性单纯性喉炎、声带角化、声带小结、声带息肉、声带囊肿、声带任克水肿、声带良性肿瘤、声门癌为R与G相关性最高(r=0.885～0.965),病理性声带沟、单侧声带麻痹、功能性发声障碍则B与G相关性最高(r=0.746～0.833)。结论GRBAS听主观评估嗓音障碍不仅可显示嗓音障碍的程度,而且可间接反映发声时声带的基本特征,不同嗓音疾病具有不同特点,与声带病变的病理生理改变具有一致性。

关键词

嗓音疾病;听主观评估

基金项目(Foundation):

作者

李红艳;徐文;胡蓉;胡慧英;侯丽珍;张丽;

参考文献

1 Bielamowicz S,Krei man J,Gerrat BR,et al.Comparison ofvoice analysis systems for perturbation measurement[J].Speech Hear Res,1996,39:126.

2 Wuyts FL,De Bodt MS,Molenberghs G,et al.The dysphoniaseverity index:an objective measure of vocal quality based on amultiparameter approach[J].J Speech Hear Res,2000,43:796.

3 Hirano M.Psycho-acoustic evaluation of voice:GRBAS Scalefor evaluating the hoarse voice[M].In:Hirano M,ed.Clinicalexamination of voice.Wien,New York:Springer-Verlag,1981.81~84.

4 Karnell MP,Melton SD,Childes J M,et al.Reliability of clini-cian-based(GRBAS and CAPE-V)and patient-based(V-RQOL and IPVI)documentation of voice disorders[J].JVoice,2007,21:576.

5 Ptok M,Schwemmle C,Iven C,et al.On the auditory evalua-tion of voice quality[J].HNO,2006,54:793.

6 Wiskirska-Wo nica B,Pruszewicz A,Obrebowski A,et al.The correlation between subjective and objective voice evalua-tionin organic and functional larynx disorders[J].OtolaryngolPol,2003,57:537.

7 Yamaguchi H,Shrivastav R,Andrews ML,et al.Acompari-son of voice quality ratings made by Japanese and Americanlisteners using the GRBAS scale[J].Folia Phoniatr Logop,2003,55:147.

8 Webb AL,Carding PN,Deary IJ,et al.The reliability ofthree perceptual evaluation scales for dysphonia[J].Eur ArchOtorhinolaryngol,2004,261:429.

9于萍,黄冬雁,Joana R,等.不同嗓音样本对嗓音听感知评估的影响[J].听力学及言语疾病杂志,2004,12:164.

10徐文,韩德民,侯丽珍,等.痉挛性发音障碍诊断及治疗的研究[J].中华耳鼻咽喉头颈外科杂志,2005,40:253.

11 Dejonckere PH,Remacle M,Fresnel E,et al.Differentiatedperceptual evaluation of pathological voice quality:Reliabilityand correlations with acoustic measurements[J].Rev Laryn-gol Otol Rhinol,1996,117:219.

本文信息

PDF(640K)

本文关键词相关文章

嗓音疾病听主观评估

本文作者相关文章

李红艳徐文胡蓉胡慧英侯丽珍张丽