早期声门型喉癌低温等离子射频消融术后联合嗓音训练的嗓音学分析  

Sonological analysis of voice training on the recovery of voice function after plasma radiofrequency ablation of early-stage glottic carcinoma

作　　者：徐萌 金晓彤 孙毓晗 李建涛 孔婷婷 XU Meng;JIN Xiaotong;SUN Yuhan;LI Jiantao;KONG Tingting(Department of Otorhinolaryngology Head and Neck Surgery,Hongqi Hospital Affiliated to Mudanjiang Medical University,Mudanjiang 157100,China)

机构地区：[1]牡丹江医学院附属红旗医院耳鼻咽喉头颈外科,黑龙江牡丹江157100

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第2期95-98,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：黑龙江省卫生健康委科研课题(2019-404)。

摘　　要：目的将嗓音训练方法应用于早期声门型喉癌等离子射频消融术后,探究其对嗓音功能恢复的影响情况。方法严格按照纳入标准选取2019年1月—2020年12月牡丹江医学院附属红旗医院耳鼻咽喉头颈外科收治的早期声门型喉癌患者60例,均在支撑喉镜下用低温等离子射频消融术切除癌灶,再将患者随机分为两组,训练组患者于术后2周开始进行为期3个月的嗓音训练治疗,对照组患者术后仅定期复查。比较两组患者术前、术后3个月主、客观嗓音情况。结果两组患者术前主、客观嗓音各项指标比较均无统计学意义(P均>0.05)。术后3个月,主观评估指标嗓音障碍指数(VHI)、CRBAS听主观评估中总嘶哑度(G)、粗糙度(R)、气息度(B)及客观评估指标基频(F0)、基频微扰(Jitter)、振幅微扰(Shimmer)、谐噪比(HNR),训练组各项主观评估指标低于对照组,差异有统计学意义(P<O.05),Jitter、Shimmer客观评估指标低于对照组,差异具有统计学意义(P<0.05),训练组的F0和HNR均值优于对照组,但差异无统计学意义(P>0.05)。结论嗓音训练联合低温等离子射频术治疗早期声门型喉癌,可以促进患者嗓音功能早期恢复,值得在临床推广应用。Objective To investigate the effect of voice training on the recovery of voice function,the voice training method was applied after plasma radiofrequency ablation of early-stage glottic carcinoma.Methods Sixty patients with early-stage glottic carcinoma admitted to department of otorhinolaryngology head and neck surgery,hongqi hospital affiliated to mudanjiang medical university from January 2019 to December 2020 were selected by standardized criteria.All patients were treated with low-temperature plasma radiofrequency ablation under supported laryngoscope,who were randomly divided into two groups.Patients in the training group received voice training for 3 months after 2 weeks of surgery.The control group only had regular review after operation.Patients in both groups were reviewed by electronic laryngoscopy.And the subjective and objective voice conditions were evaluated respectively.Results There was no statistical significance in preoperative subjective and objective voice indicators between two groups(P>0.05).The subjective evaluation indexes of voice Disorder index(VHI),total hoarseness(G),roughness(R)and breath degree(B)in the subjective evaluation of CRBAS,as well as the objective evaluation indexes of fundamental frequency(F0),fundamental frequency perturbation(Jitter),amplitude perturbation(Shimmer)and harmonic noise ratio(HNR)at 3 months of post-operation.The subjective evaluation indexes of the training group were lower than those of the control group,and the differences were statistically significant(P<0.05).The mean values of F0 and HNR in the training group were better than those in the control group,but there was no significant statistical significance(P>0.05).Conclusion Voice training combined with cryogenic plasma radiofrequency for early-stage glottic laryngeal cancer can promote early recovery of voice function in patients,which is worthy of clinical application.

关 键 词：早期声门型喉癌 低温等离子射频消融技术 嗓音训练 嗓音评估 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]