摘要
目的探讨嗓音训练对声门闭合不全的功能性嗓音障碍患者的疗效。方法对24例声门闭合不全的功能性嗓音障碍患者进行8周的嗓音训练,训练内容包括健康宣教、肌肉放松、喉部按摩、暖嗓、呼吸训练、嗓音训练和共鸣训练,训练前后对患者进行电子喉镜检查、GRBAS评估、嗓音障碍指数量表(VHI)评估、计算机嗓音声学分析,比较训练前后评估结果。结果 24例患者训练后电子喉镜检查16例患者声门闭合良好(66.67%,16/24),6例声门裂隙变小(25.00%,6/24),2例声门裂隙无明显变化(8.33%,2/24);GRBAS评分中总嘶哑度G(0.61±0.66)明显低于训练前(1.91±0.87)(P<0.05),粗糙声R(0.51±0.58)明显低于训练前(1.41±0.52)(P<0.05);VHI评分总分(29.21±21.02)分明显低于训练前的(52.35±23.45)分(P<0.05);计算机嗓音声学分析最长发声时间(15.24±3.64)s比训练前(9.02±3.45)s明显延长(P<0.05),基频微扰、最高基频、最低音强、嗓音障碍严重指数训练后分别为(0.21±0.08)%、(420.11±44.21)Hz、(54.21±3.20)d B、(1.62±0.82)比训练前的(0.92±0.12)%、(375.21±49.21)Hz、(56.81±3.42)d B、(0.21±1.02)有改善(P<0.05)。结论嗓音训练能改善声门闭合不全的功能性嗓音障碍患者的声门闭合及嗓音质量。
Objective To investigate the effectiveness of voice training for functional voice disorder in patients with glottal dysraphism.Methods Twenty-four patients suffering from functional voice disorder with glottal dysraphism went through a 8-week voice training.The training program included health education,muscle relaxation,laryngeal massage,warm voice,breathing training,voice training and resonance training.Electronic laryngoscopy,GRBAS evaluation,voice handicap index（VHI） and computer voice acoustic analysis were performed before and after the training procedure in all the patients,and the results were compared.Results After the voice training,electronic laryngoscopy revealed complete closure of glottis in 16 patients（66.67%,16/24）,smaller glottic fissure in 6（25.00%,6/24）,and unchanged glottic fissure in 2（8.33%,2/24）.As for the GRABS evaluation,the scales of grade（G）（0.61 ± 0.66） and roughness（R）（0.51 ± 0.58） after training were lower than those（1.91 ± 0.87）（1.41 ± 0.52） before training respectively,and the differences were both statistically significant（both P〈0.05）.The VHI value（29.21 ± 21.02） after training was less than that（52.35 ± 23.45） before training（P〈0.05）.The maximum phonation time（MPT）（15.24 ± 3.64） after training was longer than that（9.02 ± 3.45） before training（P〈0.05）.Computer voice acoustic analysis also showed that the Jitter,highest frequency（F0-High）,lowest intensity（I-Low） and dysphonia severity index（DSI） after training（0.21 ± 0.08%,420.11 ± 44.21 Hz,54.21 ± 3.20 d B,1.62 ± 0.82） got improved comparing with those before training（0.92 ± 0.12%,375.21 ± 49.21 Hz,56.81 ± 3.42 d B,0.21 ± 1.02）（all P〈0.05）.Conclusion Voice training can improve glottal closure and voice quality in patients of functional voice disorder with glottal dysraphism.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2017年第5期422-426,共5页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
