早期腭裂修复术对患者语音功能的影响  

Influence of early palatorrhaphy on speech function

作　　者：刘纲[1,2,3,4] 李万山[1,2,3,4] 李远贵[4] 陈吉明[4] 钟渝翔[4] 廖礼姝[4] 沈露[4] 

机构地区：[1]儿童发育疾病研究省部共建教育部重点实验室,重庆400014 [2]儿科学重庆市重点实验室,重庆400014 [3]重庆市(儿童发育重大疾病诊治与预防)国际科技合作基地,重庆400014 [4]重庆医科大学附属儿童医院口腔科,重庆400014

出　　处：《现代医药卫生》2011年第17期2569-2572,共4页Journal of Modern Medicine & Health

基　　金：重庆医科大学校办课题资助;课题编号:XB200112(婴儿期腭裂修复术对患儿语音功能的影响)

摘　　要：目的:通过对18月龄前后行腭裂修复术后患儿语音清晰度与过高鼻音的直接评估,了解早期腭裂修复术对患儿语音的影响。方法:选择符合纳入标准的早期腭裂修复患儿(A组)、延期腭裂修复患儿(B组)及正常儿童(C组)进行研究。由2名语音师采用语音字表直接对3组儿童进行语音评估获取其语音清晰度与过高鼻音,并通过统计学分析了解不同手术时机对患儿语音清晰度及过高鼻音的影响。结果:语音清晰度方面:A组患儿为78%～94%,平均88.2%;B组36%～90%,平均64.1%;C组86%～96%,平均91.4%。统计学分析发现A组与B组、B组与C组间存在差异有统计学意义(P<0.05),而A组与C组间差异无统计学意义(P>0.05)。过高鼻音方面:A组无过高鼻音3例,轻度11例,中度3例,重度0例;B组无过高鼻音0例,轻度1例,中度7例,重度11例。A组与B组间存在差异有统计学意义(P<0.05)。结论:18月龄前行腭裂修复术患儿其语音清晰度与过高鼻音均明显好于延迟手术者,早期手术有利于患儿语音功能的恢复。Objective：To investigate the effect of early palatorrhaphy on the speech outcome in 18-month-old patients with cleft palate by direct evaluating the postoperative speech intelligibility and hypernasality.Methods：The cases according with the inclusion standard were divided into 3 groups,early palatorrhaphy cases（group A）,postponing palatorrhaphy cases（group B） and normal children（group C）.Palatorrhaphy was performed in earlier and late 18 months old,respectively.The speech intelligibility and hypernasality of all the children were evaluated by 2 speech therapists through direct speech assessment respectively.And the effect of different operative timings on the speech intelligibility and hypernasality of cleft palate patients were analyzed using interclass variance analysis or t test.Results：The speech intelligibility：78%～94%（average 88.2%） in group A,36%～90%（average 64.1%） in group B and 86%-96%（average 91.4%） in group C.The statistical analysis showed significant difference between group A with group B and group B with group C（P0.05）,but no significant difference between group A and group C（P0.05）.The hypernasality： there were 3 cases without hypernasality,11 mild cases and 3 moderate cases and no severe case in group A;in group B,there were no case of hypernasality,1 mild case,7 moderate cases and 11 severe cases.There was significant difference between group A and group B（P0.05）.Conclusion：The postoperative speech intelligibility and hypernasality in the 18-month-old patients with palatorrhaphy are better than those with delayed surgery.Early palatorrhaphy is benificial to the recovery of speech function.

关 键 词：腭裂 手术时机 腭裂修复术 语音清晰度 过高鼻音 

分 类 号：R78[医药卫生—口腔医学]