利用声学语音学技术对常见类型运动性构音障碍治疗效果分析  

The Application of Acoustic and Phonetic Technologies to the Rehabilitation of the Common Subtypes of Dysarthria：The Practice and Outcomes

作　　者：张庆苏[1] 庞子健[1] 罗薇[1] 李胜利[1] 何怡[1] 

机构地区：[1]首都医科大学康复医学院,中国康复研究中心北京博爱医院听力语言科,北京100068

出　　处：《中国听力语言康复科学杂志》2016年第2期88-92,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：中央级公益性科研院所基本科研业务费专项资金资助（2012202）

摘　　要：目的利用声学语音学技术比较分析常见类型的运动性构音障碍在较短时间内（2N）康复治疗前后的效果。方法选择脑血管病后运动性构音障碍患者30例，其中痉挛型12例，弛缓型8例，共济失调型9例，混合型1例，接受2周共10次的构音障碍康复训练。治疗前后分别记录患者在深呼吸下持续发／a／音的平均最长发声时间、平均发声频率及平均发声强度，采用Kay电脑语音工作站CSL-4500型进行数据分析，比较治疗前后各类型运动性构音障碍患者的效果。结果不同类型构音障碍在发声参数上不同，其中痉挛型与弛缓型平均发声频率有显著差异（P〈0．05），痉挛型与失调型平均最长发声时间有显著差异（P〈0．05），驰缓型与失调型平均最长发声时间有显著差异（P〈0．05）。康复治疗后，所有构音障碍患者的发声强度都有显著提高（P〈0．01），发声时间和频率差异无统计学意义（P〉0．05）。痉挛型构音障碍患者发声强度变化显著（P〈0．05），弛缓型构音障碍患者最长发声时间变化显著（P〈0．05），失调型构音障碍患者发声强度及发声时间都有增加趋势，但差异无统计学意义（P〉0．05）。结论基础的呼吸与发声训练在短期内对运动性构音障碍患者发声强度的提高有明确效果；不同类型运动性构音障碍患者治疗前后的声音参数变化差异明显，需要有针对性的调整治疗策略；不同类型运动性构音障碍在声音参数上有显著差异，为运动性构音障碍的客观评价提供了方向和思路。Objective To analyze and compare the rehabilitation outcomes in common subtypes of dysarthria before and after 2 weeks of rehabilitation therapy using the acoustic and phonetic technologies. Methods Thirty patients suffering from dysarthria after the cerebrovascular disease were recruited to receive rehabilitation therapy 10 times in two weeks. Before and after the therapy, the parameters of average maximum phonation time, average phonation frequency and average phonation intensity were recorded when the patients pronounced the sound /a/ in deep breath, and analyzed by the Kay computer sound workstation（CSL-4500） to compare the rehabilitation outcomes of different subtypes of dysarthria. Results The phonation parameters were different for different subtypes of dysarthria. The difference in average phonation frequency between patients with spastic and flaccid dysarthria was significant（P〈0.05）; the difference in average maximum phonation time between patients with spastic and ataxic dysarthria was significant（P〈0.05）; the difference in average maximum phonation time between flaccid and ataxic dysarthria was significant（P〈0.05）. After the rehabilitation therapy, the phonation intensities were increased significantly in all patients（P〈0.01）,but there was no significant changes in average phonation time（P〉0.05）and frequency（P〉0.05）. There were significant differences in the phonation intensity of patients with spastic dysarthria（P〈0.05）and in the phonation time of patients with flaccid dysarthria（P〈0.05） before and after the therapy, but there was no significant difference in the parameters of patients with ataxic dysarthria（P〉0.05）even though the phonation time and intensity showed an increase. Conclusion The basic respiratory and phonation training can increase the phonation intensity of the patients with dysarthria during a short period of time. There are obvious differences in phonation parameters among patients with different subtypes of dysarthria before

关 键 词：运动性构音障碍 发声时间 频率 强度 

分 类 号：R743.306[医药卫生—神经病学与精神病学]