言语参数测量在脑损伤后神经性言语障碍患者中的应用  

The application of speech production measurements with dysarthria patients after brain injury

作　　者：范顺娟 胡瑞萍 吴军发 沈雪彦 沈莉 刘加鹏 王婷玮 吴毅 朱玉连 Fan Shunjuan;Hu Ruiping;Wu Junfa;Shen Xueyan;Shen Li;Liu Jiapeng;Wang Tingwei;Wu Yi;Zhu Yulian(Department of Physical Medicine and Rehabilitation,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院康复医学科,上海200040

出　　处：《中华物理医学与康复杂志》2020年第9期787-791,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：国家重点研发计划(2018YFC2001700);上海市科学技术委员会项目资助(17411953900,18411962300);上海市临床重点专科项目资助(shslczdzk02702);科技部重点研发课题基金(2018YFC1313600);中欧政府间合作项目(2017YFE0112000)。

摘　　要：目的探讨应用客观指标评估神经性言语障碍患者嗓音障碍的有效性,分析神经性言语障碍患者的嗓音声学特征。方法采用言语主观功能评估将29例言语障碍患者分为重度言语障碍组(19例)和轻度言语障碍组(10例),用计算机言语测量仪对患者进行评估,比较和分析2组患者的最长声时(MPT)、最大数数能力(MCA)、平均基频、基频标准差、基频范围、平均强度、共振峰、下颌距和舌距的异常发生比率及其均值差异。结果所有患者的MPT和MCA值均存在异常,且重度组患者的MPT值[(4.37±3.89)s]明显短于轻度组[(8.22±4.03)s],MCA值[(3.39±3.77)s]亦明显弱于轻度组[(8.56±3.24)s],组间差异均有统计学意义(P<0.05)。重度组在平均基频、基频标准差、F2(i)以及舌距指标中存在异常情况的比率为73.68%、63.16%、73.68%和78.95%,明显高于轻度组(30.00%、30.00%、30.00%和40.00%),且组间差异均有统计学意义(P<0.05)。结论言语参数测量可以有效评估脑损伤后神经性言语障碍患者的言语功能;神经性言语障碍患者出现言语呼吸功能受损的现象非常普遍,值得重视。Objective To explore the effectiveness of evaluating voice disorders in dysarthria patients after brain injury using speech production measurements and analyze their phonics characteristics.Methods Twenty-nine patients were divided into a severe dysarthria group(n=19)and a mild dysarthria group(n=10)through the subjective evaluation of their speech,and then evaluated using a computer speech monitor.The maximum phonation time(MPT),maximum counting ability(MCA),basic frequency(F0),standard deviation of F0(F0SD),F0 range,intensity,formant,and the distance of jaw and tongue movements were recorded.Results All of the patients displayed abnormal MPTs and MCAs,with the average MPT and MCA of the severe dysarthria group significantly lower than the mild group′s averages.In the severe dysarthria group,the abnormal F0s,F0SDs,F2(i)s and tongue movement distances were significantly greater than in the mild group.Conclusions Speech production measurements can be applied to evaluate the speech dysarthria patients after brain injury.It is very common for such patients to have impaired speech and respiratory function,so this is worthy of attention.

关 键 词：构音困难 言语参数测量 康复 语音学 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]