摘要
【目的】探讨嗓音训练联合神经肌肉电刺激(嗓音训练—物理因子模式)治疗术后声带麻痹患者的疗效。【方法】收集我院2018年11月1日至2019年12月31日术后声带麻痹的42例患者的临床资料,采用嗓音训练-物理因子模式治疗,1个月后,评估治疗前后嗓音障碍指数量表(VHI)、最长发声时间(MPT)、声带运动情况的变化;统计分析采用SPSS22.0软件,配对t检验对比治疗前后相应指标的变化,通过亚组分析研究嗓音训练—物理因子模式治疗疗效与患者年龄、性别、手术方式、术中喉返神经保护情况、介入治疗时机之间是否存在相关性。【结果】嗓音训练-物理因子治疗模式可以有效降低VHI量表中的功能、生理、情感3个模块的评分(11.78±3.06,P<0.001;9.9±2.8,P<0.001;9.7±3.13,P<0.001),同时能延长MPT(5.62±3.88,P<0.001),显著改善声带闭合程度(Z=5.62,P<0.001)。未发现不同年龄、性别、手术方式、康复治疗介入时机、术中喉返神经保护情况的亚组之间疗效有显著差异。【结论】通过嗓音训练—物理因子治疗模式对术后声带麻痹的恢复具有促进作用,其对于在不同时机介入治疗、年龄、性别、术式的患者均有显著疗效。
【Objective】This study aims to explore the therapeutic effect of voice therapy combined with neuromuscular electrical stimulation(voice-physical therapy)on patients with postoperative vocal cord paralysis.【Methods】Totally 42 patients diagnosed with postoperative vocal cord paralysis from November 1,2018 to December 31,2019 in our center were included in this study.These patients were divided into different sub-groups according to their age,sex,surgical procedure,preservation of recurrent laryngeal nerve and intervention timing.Voice handicap index(VHI),maximum phonation time(MPT)and vocal cord mobility were investigated before and after one-month voice-physical therapy.T-test was used to evaluate the variation of these factors,with SPSS 22.0.The correlation between the effect of this therapy and age,gender,surgical procedure,preservation of recurrent laryngeal nerve and intervention timing was further investigated with subgroup analyses.【Results】Voice-physical therapy could significantly reduce the scores of functional(11.78±3.06,P<0.001),physical(9.9±2.8,P<0.001)and emotional sections(9.7±3.13,P<0.001)in the VHI scale.It could also prolong the MPT(5.62±3.88,P<0.001),and significantly improve vocal cord closure(Z=5.62,P<0.001).No significant differences of therapeutic effect were found among different subgroups of age,gender,surgical procedure,preservation of recurrent laryngeal nerve and intervention timing.【Conclusions】Voice-physical therapy promotes the recovery of postoperative vocal cord paralysis.This effect exists regardless of different intervention timing,age,gender,surgical procedures and status of preservation of recurrent laryngeal nerve.
作者
宁莉
陈颖乐
方雪梅
陈丽慧
林泳琴
陈艳峰
NING Li;CHEN Ying-le;FANG Xue-mei;CHEN Li-hui;LIN Yong-qin;CHEN Yan-feng(Department of Head and Neck Surgery,Sun Yat-sen University Cancer Center//State Key Laboratory of Oncology in South China//Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2021年第1期109-116,共8页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省食管癌研究所科技计划项目(M201811)。
关键词
嗓音训练
神经肌肉电刺激
甲状腺癌
声带麻痹
voice therapy
neuromuscular electrical stimulation
thyroid cancer
vocal cord paralysis
