气流相关检查参数对嗓音功能评估的意义  

Significance of certain experiments relevant to airflow parameters in assessment of voice function

作　　者：余明强[1] 潘晗[1] 周莉[1] 焦彦超[1] 荆岳商士商 庄佩耘[1] 

机构地区：[1]厦门大学附属中山医院耳鼻咽喉科,361004

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第12期983-988,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金（81371080）

摘　　要：目的探讨与气流相关的检查参数对嗓音功能评估的意义。方法对声带良性增生性疾病患者和正常嗓音者进行s／z比值测量、肺功能检查和喉空气动力学检查。运用空气动力学参数评估声带良性增生性疾病患者治疗全过程的效果。结果疾病组的s／z比值高于正常嗓音组（P〈0．05）。在男性组中，肺功能参数用力呼气峰值流速（PEF）值在疾病组和正常组间差异有统计学意义（P〈0．05）。不同性别组内的疾病组和正常组之间的空气动力学参数（平均气流速率、最长发声时间、发音阈气流、声门下压力、发音阈压、发声效率）的差异均有统计学意义（P〈0．05）。术后男女组的空气动力学参数（平均气流速率、最长发声时间、发声阈气流、发声阈压、声门下压力）相对于术前均显著改善（P〈0．05）。根据患者术前及术后1个月的喉镜评估分为两组：评估较差组（伴有功能性或除声带增生性病变以外其他器质性的喉部异常）和评估较佳组。术后：喉镜下评估较差组和正常组主要在发音阈气流、发音阈压、声门下压力、发声效率方面差异有统计学意义（P〈0．05）；喉镜下评估较佳组和正常组间差异无统计学意义（P〉0．05）。喉镜下评估较差组术后1个月接受8周嗓音训练后喉空气动力学参数和正常组差异无统计学意义（P〉0．05）。结论s／z比值、空气动力学参数对于声带增生性疾病的诊断和评估具有较大的价值。喉空气动力学检查可以敏感、准确地反映治疗过程中嗓音功能的变化。嗓音训练可以明显改善声带术后患者的发声功能。Objective To investigate the role of airflow parameters of some specific examinations in voice function assessment. Methods The s/z ratio, pulmonary function and phonatory aerodynamic parameters were measured in subjects with benign vocal fold lesions and with normal voice. The effect of treatment in subjects with benign vocal fold lesions was evaluated with the phonatory aerodynamic parameters. Results The value of s/z ratio in the disease group was higher than that in the normal group （ P 〈 0.05 ）. The value of PEF was significantly different between the disease group and the normal group for male（P 〈 0.05）. MFR, MPT, PTF, SGP, PTP, VE were significantly different between the disease group and the normal group（P 〈0.05）. MFR, MPT, PTF, SGP, PTP of the disease group after surgery for both sex were significantly different from before surgery （ P 〈 0.05 ）. The disease group was subdivided into two groups through stroboscopic examination before and one month after surgery： the worse group （with some functional laryngeal abnormality, or organic abnormality except benign vocal fold lesion ） and the better group. PTF, PTP, SGP, VE were significantly different between the worse group and the normal voice group. There was almost no significant difference for aerodynamic parameters between the better group and the normal voice group （P 〉 0.05 ）. There was no significant difference between the worse group after 8 weeks＇voice training and the normal voice group （ P 〉 0.05 ）. Conclusions s/z ratio, aerodynamic parameters （MFR, MPT, SGP, PTF, PTP, VE） are valuable for the diagnosis and assessment of the voice disorders. Aerodynamic parameters are sensitive to the change of glottal function during the treatment. Voice training can increase the glottal function of patients after laryngeal microsurgery.

关 键 词：发音困难 语音障碍 峰值呼气流速 最大呼气流速 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]