伴咽喉反流的声带息肉患者嗓音质量分析

Voice Quality Analysis of Vocal Cord Polyps Patients with Laryngopharyngeal Reflux

肖翠;余林;傅然;胡鸿敏;

1:重庆医科大学附属第一医院耳鼻咽喉科

摘要

目的分析伴咽喉反流的声带息肉患者嗓音质量,探讨咽喉反流对其嗓音及生活质量的影响。方法选取成年声带息肉患者79例,其中反流症状指数(reflux symptom index,RSI)量表>7且反流体征指数(reflux finding score,RFS)量表>13或既往诊断有咽喉反流的患者22例(反流组),余57例作为对照组,两组均进行电子鼻咽喉镜检查、嗓音障碍指数量表(voice handicap index,VHI-10)评分、嗓音相关生活质量(voice-related quality of life,V-RQOL)、GRBAS分级(采用总体感知分级G)与嗓音声学检测,比较两组结果。结果反流组VHI-10评分均值、V-RQOL评分均值及G分级(分别为18.73±9.533、58.76±19.29分及2.27±0.631级)和对照组(分别为12.96±7.655、73.97±18.97分及1.92±0.625级)间的差异有统计学意义(P=0.007、P=0.002、P=0.028);两组间jitter、shimmer、MPT及DSI均值差异无统计学意义(P=0.657、P=0.129、P=0.199、P=0.957);反流组中广基和双侧声带息肉的发生率(72.7%、77.3%)明显高于对照组(45.6%、47.4%),差异有统计学意义(P=0.030、0.016)。结论咽喉反流可影响声带息肉患者的心理和生活质量,加重嗓音嘶哑度,咽喉反流与广基及双侧声带息肉的发生可能有相关性。

关键词

声带息肉;咽喉反流;嗓音质量

基金项目(Foundation):

作者

肖翠;余林;傅然;胡鸿敏;

参考文献

1 严森,徐文,李赟,等.咽喉反流与嗓音疾病的相关分析[J].听力学及言语疾病杂志,2014,22:34.

2 Lechien JR,Saussez S,Nacci A,et al.Association between laryngopharyngeal reflux and benign vocal folds lesions:a systematic review[J].Laryngoscope,2019,129:E329.

3 Chung JH,Tae K,Lee YS,et al.The significance of laryngopharyngeal reflux in benign?vocal mucosal lesions[J].Otolaryngol Head Neck Surg,2009,141:369.

4 Lechien JR,Khalife M,Huet K,et a1.Perceptual,aerodynamic,and acoustic characteristics of voice changes in patients with laryngopharyngeal reflux disease[J].Ear Nose Throat J,2019,98:E44.

5 张帆,姚利,郑世信.咽喉反流与嗓音疾病相关性初步评估[J].重庆医学,2017(46):35.

6 李进让,肖水芳,李湘平,等.咽喉反流性疾病诊断与治疗专家共识(2015年)解读[J].中华耳鼻咽喉头颈外科杂志,2016,51:327.

7 Lu D,Wen B,Yang H,et al.A Comparative study of the VHI-10 and the V-RQOL for quality of life among Chinese teachers with and without voice disorders[J].Journal of Voice,2017,31:509.

8 李红艳,徐文,胡蓉,等.嗓音障碍疾病GRBAS听主观评估特点分析[J].听力学及言语疾病杂志,2009,17:60.

9 秦辉.咽喉反流和嗓音疾病相关性的初步探讨[J].四川医学,2015,36:1621.

10 徐志鸿,何锦添,钟景良,等.声带息肉与咽喉反流的相关性研究[J].实用医学杂志,2013,29:1805.

11 李丽娜,张延平,周凤书,等.咽喉反流与声带息肉之间的相关性研究[J].中国耳鼻咽喉颅底外科杂志,2012,18:431.

12 Bardhan KD,Strugala V,Dettmar PW.Reflux revisited:advancing the role of pepsin[J].International Journal of Otolaryngology,2012,2012:646901.

13 Johnston N,Wells CW,Blumin JH,et al.Receptor-mediated uptake of pepsin by laryngeal epithelial cells[J].Ann Otol Rhinol Laryngol,2007,116:934.

14 Samuels TL,Johnston N.Pepsin as a causal agent of inflammation during nonacidic reflux[J].Otolaryngology Head and Neck Surgery,2009,141:559.

15 Johnston N,Dettmar PW,Bishwokarma B,et al.Activity/stability of human pepsin:implications for reflux attributed laryngeal disease[J].The Laryngoscope,2007,117:1036.

16 Koufman JA.Low-acid diet for recalcitrant laryngopharyngeal reflux:therapeutic benefits and their implications[J].Annals of Otology Rhinology & Laryngology,2011,120:281.

17 Patterson N,Mainie I,Rafferty G,et al.Nonacid reflux episodes reaching the pharynx are important factors associated with cough[J].J Clin Gastroenterol,2009,43:414.

18 Spantideas N,Drosou E,Bougea A,et a1.Proton pump inhibitors for the treatment of laryngopharyngeal reflux.A systematic review[J].J Voice,2019:S0892

19 于萍,王荣光.嗓音障碍主观听感知评估研究现状[J].听力学及言语疾病杂志,2009,17:1.

20 魏春晖,张道行.声带息肉的大小对嗓音参数的影响[J].中国中西医结合耳鼻咽喉科杂志,2010,18:198.

21 Akbari E,Seifpanahi S,Ghorbani A,et al.The effects of size and type of vocal fold polyp on some acoustic voice parameters[J].Iran J Med Sci,2018,43:158.

22 张帆,姚利,彭一纯,等.嗓音障碍严重指数在咽喉反流相关嗓音疾病中的应用研究[J].临床耳鼻咽喉头颈外科杂志,2017,31:46.

23 周舟,葛平江,刘倩,等.嗓音障碍严重指数评价声带息肉手术疗效的研究[J].中华耳鼻咽喉头颈外科杂志,2015,50:673.

24 Lechien JR,Saussez S,Harmegnies B,et al.Laryngopharyngeal reflux and voice disorders:a multifactorial model of etiology and pathophysiology[J].Journal of Voice,2017,31:733.

25 吴修法,徐洁洁,乔明哲,等.反流性咽喉病患者嗓音声学特征分析[J].听力学及言语疾病杂志,2012,20:221.

本文信息

PDF(130K)

本文关键词相关文章

声带息肉咽喉反流嗓音质量

本文作者相关文章

肖翠余林傅然胡鸿敏