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康复训练疗法对胸腔手术后单侧声带麻痹患者嗓音与吞咽障碍的改善作用

Effects of rehabilitation therapy on voice and swallowing disorders in patients with unilateral vocal cord paralysis after thoracic surgery

王璐;赵大庆;任盼;刘静

1:空军军医大学第二附属医院耳鼻咽喉头颈外科

摘要
目的 初步探究康复训练治疗法对心胸外科手术后单侧声带麻痹患者发音及吞咽功能恢复的效果。方法 对心胸外科手术后并发声带麻痹的患者28例，实施12周的嗓音与吞咽康复训练，每周2次，每次0.5～1 h。康复训练前后以GRBAS评估系统、嗓音障碍指数量表(voice handicap index, VHI)、计算机嗓音分析仪、最大音量发声时间(maximum loudness phonetic time, MLPT)和最长发声时间(maximum phonetic time, MPT)等主客观指标评估嗓音质量；应用误吸等级评估法及纤维内窥镜吞咽检查(fiberoptic endoscopic evaluation of swallowing, FEES)对吞咽功能进行评估。结果 康复训练后，所有患者发音功能较训练前均有改善，总嘶哑度、气息度、无力度等评分均较训练前降低(P<0.05);VHI各维度评分和总分及计算机嗓音分析的基频微扰、振幅微扰均低于康复训练前(P<0.05);MLPT和MPT时间均较训练前延长(P<0.05)。吞咽障碍患者进食呛咳情况均得到改善，误吸评级等较训练前明显降低，差异具有统计学意义(P<0.05),未发生吸入性肺炎等并发症。结论 康复训练可有效改善心胸外科手术后声带麻痹患者的嗓音质量与吞咽功能，具有临床推广应用价值。
关键词
声带麻痹;康复治疗;嗓音障碍;吞咽障碍
基金项目(Foundation):
陕西省重点产业创新链重点项目(2019ZDLSF02-01);; 空军军医大学第二附属医院学科创新发展计划项目(2021QYJC-006);; IIT临床研究项目(2022XJSXYW-011)
作者
王璐;赵大庆;任盼;刘静
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声带麻痹康复治疗嗓音障碍吞咽障碍

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王璐赵大庆任盼刘静