ABCLOVE嗓音训练法治疗声带息肉的临床观察  

Evaluation of ABCLOVE voice therapy program outcomes for patients with vocal cord polyps

作　　者：赵大庆[1] 崔鹏程[1] 王璐[1] 任盼[1] 

机构地区：[1]第四军医大学唐都医院耳鼻咽喉头颈外科,陕西西安710038

出　　处：《中国耳鼻咽喉颅底外科杂志》2017年第5期409-412,417,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金面上项目(31370981)

摘　　要：目的观察应用ABCLOVE嗓音训练法治疗单侧声带息肉患者发音障碍的临床效果。方法选取2015年12月~2017年3月确诊为单侧声带息肉并伴有发音障碍的患者32例。所有患者均采用ABCLOVE嗓音训练法进行嗓音康复训练,每周1次,训练次数共6次。治疗前后应用电子喉镜、嗓音障碍指数量表(VHI)和计算机嗓音分析仪进行主客观嗓音障碍程度评估,以嗓音嘶哑指数(RAP%)、最长发声时间(MPT)、基础音频范围(Hz)和息肉大小等指标评判治疗效果。结果应用ABCLOVE嗓音训练法进行嗓音康复训练后,所有患者发音均有改善,总有效率达100%,治愈率86.3%。(1)治疗后复查电子喉镜有9例患者声带息肉消失,11例声带息肉较治疗前缩小,12例声带息肉无明显改变患者因声嘶等症状明显缓解达到日常用声需求,从而避免了手术治疗;(2)治疗后VHI评分(功能、生理、情感和总体评分)均较治疗前明显降低(P<0.05);(3)嗓音分析结果提示,嗓音嘶哑指数(RAP)较治疗前显著下降(P<0.01),最长发声时间(MPT)训练后较前显著延长(P<0.01),基础音频范围(Hz)和音强(d B)等指标均较治疗前明显提高(P<0.05)。结论 ABCLOVE嗓音训练法可针对声带息肉等临床常见喉部炎性病变造成的发音障碍进行有效的个体化治疗,从而改善发音、提高生活质量,同时避免不必要的常规手术,达到减少患者痛苦和治疗费用目的。Objective To observe the effect of ABCLOVE voice therapy program for dysphonia in patients with unilateral vocal cord polyp.Methods 32 patients suffering from unilateral vocal cord polyp with dysphonia were selected in our department from Dec 2015 to March 2017.All patients received ABCLOVE voice therapy program once a week for 6 times.Before and after voice training,they were asked to take subjective and objective evaluations via laryngoscopy,voice handicap index scale（VHI scale） and computer voice acoustic analyzer.Parameters including RAP,the maximum phonation time（MPT）,base audio range and size of polyp were used to evaluate the outcomes of ABCLOVE voice therapy program.Results After the voice rehabilitation training with ABCLOVE voice therapy,all patients had improved voice quality with a total effective rate of 100% and cure rate of 86.3%.（1） After treatment,electronic laryngoscopy showed that vocal cord polyps disappeared in 9 cases,size of polyps got decreased in 11 and remained unchanged in 12.For those with residual or unchanged polyps,surgical treatment was avoided due to significant remission of hoarseness to the extent that could meet the daily acoustic demand.（2） The VHI（F,P,E and TVH） scores after voice therapy were lower than those before treatment（all P〈0.05）.（3） Results of voice analysis showed that RAP was decreased（P〈0.01）,MPT was significantly lengthened（P〈0.01）,base audio range（Hz） and intensity（d B） were significantly improved（both P〈0.05） after treatment.Conclusions ABCLOVE voice therapy program can be effectively used for individualized treatment of dysphonia caused by laryngeal inflammatory diseases such as vocal cord polyps.Thereby,the quality of voice can be improved,and the unnecessary routine operation can be avoided,the suffering and the treatment cost of patients can be lessened.

关 键 词：ABCLOVE嗓音治疗法 声带息肉 发音障碍 言语治疗 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]