咽成形术后语音治疗效果的CSL评定  

The CSL evaluation of speech therapy after palatopharyngoplasty

作　　者：蒋莉萍[1] 王国民[1] 杨育生[1] 陈阳[1] 刘琼[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科唇腭裂治疗中心,上海200011

出　　处：《中国口腔颌面外科杂志》2010年第6期509-512,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(08DZ2271100);上海市重点学科建设项目(S30206);上海市卫生局资助课题(2008160);上海市教育委员会曙光计划资助项目(2000SG41)~~

摘　　要：目的:运用计算机语音处理系统(computerspeechlab,CSL)对咽成形术后语音障碍患者的异常辅音(塞擦音、擦音)进行治疗前、后的语音频谱分析,以期对腭咽成形术后患者的语音治疗效果进行定量和图形化分析。方法:腭咽成形术后存在语音障碍患者(清晰度<35%)40例,男24例,女16例,平均年龄11.48岁。语音治疗前、后分别将辅音音节、字表、词组和短句输入CSL,通过频谱图对含塞擦音(z、c、j、q)和擦音(s、x)的音节(zi、ci、si、ji、qi、xi)中的辅音除阻段的嗓音起始时间(VOT)进行分析,得出量化值,进行统计学分析;在频谱图上,根据治疗前、后有无冲直条和乱纹分布情况进行归纳,评价语音治疗效果,以此评判CSL的应用价值。用SPSS11.5软件包对数据进行t检验。结果:CSL测定结果显示,40例患者的VOT值由治疗前的0.0571s提高到治疗后的0.2262s,经t检验,P<0.01,具有显著差异;频谱图结果显示,代表塞的冲直条由治疗前消失到治疗后清晰可见或以整齐乱纹开始(z36/40、c30/40、j34/40、q28/40),代表擦音的乱纹由治疗前稀疏或消失到治疗后的均匀整齐,并有强频集中区。结论:运用CSL检测分析得出,腭咽成形术后严重语音障碍患者可通过语音治疗达到近似正常人的语音清晰度。CSL的定量和图形化分析,提高了语音治疗效果评价的水平。PURPOSE：To analyze the consonants and affricates before and after speech therapy via computer speech lab（CSL）,and find a method which can evaluate the efficacy of speech therapy after palatopharyngoplasty quantitatively and graphically.METHODS：Forty patients with severe phonological disorder after palatopharyngoplasty were included in this study.The ratio of male and female was 24：16,and the mean age was 11.48 years old.The consonant syllable,character table,phrase and short sentence,and of all patients were recorded.The（zi,ci,si,ji,qi,xi）of（z,c,j,q）and（s,x） were inputed into CSL and the voice onset time（VOT）was transformed into quantization value using spectrogram to be further statistically analyzed.The occurrence of vertical and disarrayed striations before and after speech therapy were also analysed in spectrogram.The data were analyzed with SPSS 11.5 software package for Student＇s t test.RESULTS：The average VOT was increased to 0.2262s after treatment from 0.0571s before treatment,and the results of t test suggested significant difference（P0.01）.The spectrogram analysis showed distinct vertical and regular striations with region after treatment,compared with none vertical and obscure disarrayed striations before treatment.CONCLUSION：The results of CSL analysis showed that severe phonological disorder after palatopharyngoplasty can be improved to nearly normal after speech therapy.The quantitative and graphics mode analysis of CSL promotes the ability of efficacy evaluation of speechtherapy significantly.

关 键 词：腭咽成形术 语音障碍 语音治疗 计算机语音处理系统评定 

分 类 号：R782.23[医药卫生—口腔医学]