四部矫治康复训练在声带良性病变手术患者中的应用研究  

Application of rehabilitation training for four-part correction in patients undergoing surgical treatment of benign vocal cord lesions

作　　者：赵春娜[1] 黄永望[1] 潘静 傅德慧[1] 赵京 庄丕伟 尤海燕 于金宝 李恺玥 ZHAO Chunna;HUANG Yongwang;PAN Jing;FU Dehui;ZHAO Jing;ZHUANG Piwei;YOU Haiyan;YU Jinbao;LI Kaiyue(Otolaryngological Department,The Second Hospital of Tianjin Medical University,Tianjin,300211,China;不详)

机构地区：[1]天津医科大学第二医院耳鼻喉科,天津市300211 [2]天津中医药大学第一附属医院急症部

出　　处：《中华护理杂志》2022年第1期10-16,共7页Chinese Journal of Nursing

基　　金：天津市护理学会青年科研课题项目(tjhlky2020QN06);天津医科大学第二医院青年科研基金项目(2019ydey23)。

摘　　要：目的探讨四部矫治康复训练在声带良性病变手术患者中的应用效果。方法便利选取2020年4月—2021年3月在天津市某三级甲等医院耳鼻喉科,首次行全麻支撑喉镜下显微手术治疗的106例声带良性病变患者为研究对象,采用随机数字表法分为试验组55例和对照组53例。试验组在常规护理基础上进行四部矫治康复训练,对照组接受常规护理方案。于入院当天、出院当天、术后2周、术后4周使用嗓音障碍指数量表(Voice Handicap Index,VHI)和多维嗓音分析软件进行评价,对VHI评分、噪谐比(noise to harmonic ratio,NHR)、振幅微扰(Shimmer)、基频微扰(Jitter)、最长发声时间(maximum phonation time,MPT)进行比较和分析。结果两组术后2周和术后4周的VHI评分、NHR、Shimmer、Jitter、MPT比较,差异具有统计学意义(均P<0.05),试验组优于对照组。各组随着出院时间的增加VHI评分、NHR、Shimmer、Jitter逐渐下降,MPT逐渐增高,两组存在时间和组间的交互作用(P<0.05)。结论四部矫治康复训练能够有效改善声带良性病变手术患者嗓音障碍主观感受和嗓音声学指标,纠正患者不良用嗓习惯和行为,促进患者康复。Objective To explore the application effect of four-part correction rehabilitation training in patients with vocal cord benign lesions.Methods A total of 106 patients with benign vocal cord lesions undergoing microsurgery under general anesthesia for the first time in the department of otolaryngology of a tertiary A hospital in Tianjin from April 2020 to March 2021 were selected and divided into an experimental group and a control group by random number table method,with 55 patients in the experimental group and 53 patients in the control group.The experimental group was given four-part correction rehabilitation training on the basis of routine nursing,and the control group received routine nursing program.The voice handicap index and multidimensional voice analysis were used for evaluation.The voice impairment index(VHI)and acoustic parameters(NHR),Shimmer,Jitter and MPT were compared and analyzed on the day of admission,the day of discharge,2 weeks and 4 weeks after surgery.Results There was no statistical significance in NHR,Shimmer,Jitter,MPT and VHI values on the day of admission and discharge between the 2 groups(P>0.05).The data of 2 weeks and 4 weeks after surgery were compared between the 2 groups,and the NHR,Shimmer,Jitter and VHI values of the experimental group were lower than those of the control group,while the MPT value was higher.The differences between the 2 groups were statistically significant(P<0.05).Conclusion Four-part correction rehabilitation training can effectively improve the subjective feeling and voice quality of patients with voice disorders after surgery for benign vocal cord lesions,help to change patients’bad voice habits and behaviors,and promote the rehabilitation of patients.

关 键 词：四部训练 声带良性病变 耳鼻咽喉科学 康复护理 

分 类 号：R473.76[医药卫生—护理学]