完全性腭裂术后儿童嗓音主、客观评估及相关性分析  

Subjective and Objective Evaluation of Voice Quality and Correlation Analysis in Children post Operation for Complete Cleft Palate

作　　者：梁峻波 高晓慧[1] 张艳丽[1] 王勇丽[1] 万勤[1] 周励 

机构地区：[1]华东师范大学言语听觉康复科学系,上海市200062 [2]长海医院耳鼻咽喉科,上海市200433

出　　处：《中国康复理论与实践》2015年第6期695-700,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金青年项目(No.81301678)

摘　　要：目的从主观和客观两个方面研究完全性腭裂术后儿童的嗓音特点,并探索主、客观各评估结果的相关性。方法对30例完全性术后腭裂儿童和34例正常儿童的自然/a/音进行电声门图分析,并比较两类儿童的差异;对腭裂儿童长音/a/进行GRBAS(嘶哑度、粗糙度、气息度、紧张度、无力度)听主观评估,并分析其主、客观各评估结果的相关性。结果完全性腭裂术后儿童的基频(F0)、谐噪比(HNR)分别小于普通儿童,其振幅微扰(shimmer)、基频微扰(jitter)和标准化噪声能量(NNE)均明显大于普通儿童,其鼻流量大于普通儿童。完全性术后腭裂儿童的主观评估中G、R评级主要为1级、2级,不足一半的腭裂儿童存在气息音、且评级主要为1级、2级。完全性术后腭裂儿童GRBAS评级中除G、R、B与F0存在中等程度相关外,主、客观评估结果之间均为弱相关或极弱相关。结论完全性腭裂术后儿童发声时声带振动较普通儿童更慢,声带振动的规律性更差;其嗓音的主观及客观评估结果均提示其存在轻、中度的嗓音音质异常,听感上存在嘶哑声、粗糙声及一定程度的气息声。嗓音的主、客观评估之间相关性低或极低。评价腭裂儿童的嗓音时,应该综合采用客观和主观的评估方法。Objective To analyze the voice quality of children post operation for complete cleft palate through subjective and objective evaluation and explore the correlation between them. Methods Electroglottography analysis was used in the natural sound/a/of 30 postoper- ative children with complete cleft palate and 34 normal children, and the difference was compared. The natural prolonged sound/a/was as- sessed with GRBAS （grade, roughness, breathiness, asthenia, strain） in the children with complete cleft palate, and the correlation between the subjective and objective results was analyzed. Results F0, harmonic to noise ratio （HNR） were less, and the shimmer, jitter, normalized noise energy （NNE） and nasalance was greater in postoperative children with complete cleft palate than in normal children. For the children with complete cleft palate, G and R mainly rated as levels 1 and 2, B also rated as levels 1 and 2 in less than half of the children. There were low or very low correlation between all subjective and objective results, excepted G, R, B and F0, which showed moderate correlation. Con- clusion The vocal cords vibrate slowly and irregularly in postoperative children with complete cleft palate, suggesting mild and moderate voice disorder, and they sound hoarsely with roughness and breathiness. There are poor correlations between the subjective and objective as- sessment, and need to be used in combination for the children with complete cleft palate.

关 键 词：完全性腭裂 嗓音 主观 客观 相关性分析 

分 类 号：R782.2[医药卫生—口腔医学]