计算机声学测试在功能性发音障碍诊断和治疗中的应用  

Application of acoustic analysis by computer in diagnosis and voice therapy of functiona dysphonia

作　　者：陆美萍[1] 徐洁洁[1] 陈曦[1] 王娟[1] 

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2008年第11期1465-1467,1473,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省卫生厅回国人员科研启动基金(EC9603);江苏省科技厅国际合作科研基金(DE9903)

摘　　要：目的:观察功能性发音障碍嗓音声学参数及声谱罔特征并进行视听反馈性发声训练,探讨计算机声学测试技术在功能性发音障碍诊断和治疗中的应用价值。方法:采用计算机嗓音声学测试系统对68例功能性发音障碍患者及50例正常成人嗓音元音信号"α"进行测试,观察分析声学参数jitter、shimmer、NNE及声谱图特征,同时利用同一软件对功能性发音障碍患者进行视听反馈性发声训练,并观察治疗前后声学特征的改变。结果:功能性发音障碍嗓音shimmer、NNE值较正常升高并有统计学意义:声谱图主要表现中、高频区谐波及共振峰病理改变。75%(51/68)患者能在某次元音信号的一段或几段声样中找到正常声学特征。通过视听反馈矫治86%(59/68)患者首次门诊就诊时即能掌握正确的发声方法,声学测试可显示一次元音信号的全程声样出现正常或明显改善的声学参数及声谱图。结论:计算机声学测试可通过观察嗓音的声学特征与器质性发音障碍相鉴别,视听反馈性发声训练简单、直观、有效。Objective：To investigate the characteristics of acoustic parameters and spectrograph of functional dysphonia （FD） and the effect of visual-hearing biofeedback voice therapy, to evaluate the value of acoustic analysis technique by computer in diagnosis and voice therapy of FD. Methods：The voice signals of sustained vowel ＂α＂ were measured with a microcomputer in 68 patients with functional dysphonia and 50 healthy adults. The acoustic parameters （jitter, shimmer, NNE） and spectrographic characteristic were analyzed and compared. The patients were trained by visual-hearing biofeedback voice therapy with the same microcomputer and the effect were evaluated. Results：In 68 cases with functional dysphonia, the shimmer and NNE were significantly increased and the jitter was slightly increased. The spectrograph showed pathologic changes of harmonic waves and formants in middle and high frequencies. The normal acoustic characteristics could be found in 75% （51/68） of the patients with functional dysphonia. 86% （59/68） of the patients with functional dysphonia could pronounced correctly after voice therapy in the first visit. Conclusion：The acoustic analysis by computer technique is useful in the diagnosis of functional dysphonia. The visual-hearing voice therapy by the microcomputer is simple, direct-viewing and effective.

关 键 词：功能性发音障碍 声学分析 视听反馈 

分 类 号：R767.64[医药卫生—耳鼻咽喉科]