甲状腺术后早期嗓音康复训练有效性的Meta分析  

Effectiveness of early voice rehabilitation training after thyroid surgery:a Metaanalysis

作　　者：田甜 张洁 刘艳琳 王娟[2] TIAN Tian;ZHANG Jie;LIU Yan-lin;WANG Juan

机构地区：[1]甘肃中医药大学护理学院,甘肃兰州730000 [2]甘肃省肿瘤医院头颈二科,甘肃兰州730050

出　　处：《中国疗养医学》2024年第8期6-10,共5页Chinese Journal of Convalescent Medicine

基　　金：国家临床重点专科建设项目(甘财社[2021]80号);甘肃省头颈肿瘤临床医学研究中心项目(21JR7RA678)。

摘　　要：目的评价早期嗓音康复训练对甲状腺切除术后嗓音异常及发音障碍患者的影响。方法检索Pub Med、Embase、Web of Science、Cochrane Library、CNKI、万方等数据库,搜集从建库至2023年10月25日发表的关于早期嗓音康复训练的随机对照试验,筛选、纳入文献,评价纳入文献质量。采用Rev Man 5.4软件,从嗓音障碍程度、客观声学指标、最长发声时间、声门闭合程度及嗓音总嘶哑度来评估甲状腺切除术后嗓音异常患者进行早期嗓音康复训练的有效性。结果最终共纳入9篇文献,共654名患者。结果显示,嗓音障碍程度(MD=-7.73,95%CI:-13.42,-2.03,P=0.008)、客观声学指标[基频F0(MD=18.19,95%CI:11.27,25.12,P<0.001),基频微扰Jitter(MD=-0.12,95%CI=-0.20,-0.03,P=0.006),振幅微扰Shimmer(MD=-0.51,95%CI:-0.98,-0.05,P=0.03)]、最长发声时间(MD=2.21,95%CI:0.91,3.51,P<0.001)、声门闭合程度(MD=-0.38,95%CI:-0.48,-0.29,P<0.001)、总嘶哑度(MD=-0.13,95%CI:-0.19,-0.07,P<0.001)。结论早期嗓音康复训练可改善甲状腺切除术后嗓音异常患者的发声能力、嗓音粗糙度、嘶哑度、最长发声时间、声门闭合程度及嗓音障碍程度,对声带运动产生积极作用,可改善声门间隙闭合。Objective Evaluate the effect of early voice rehabilitation training on patients with voice abnormalities and pronunciation disorders after thyroidectomy.Methods Randomized controlled trials(RCTs)reporting an early voice rehabilitation trainingpublished until 25th October 2023 were searched in PubMed,Embase,Web of Science,Cochrane Library,CNKI,and Wanfang database.Eligible articles were screened and assessed for their quality.The Rev Man 5.4 software was used to evaluate the effect of early voice rehabilitation training on voice disorder,objective acoustic index,the longest vocal duration,glottal closure and total voice hoarseness.Results Nine articles representing 654 patients were included.Degree of voice disorder(MD=-7.73,95%CI:-13.42,-2.03,P=0.008),acoustic voice analysis(fundamental frequency of F0[MD=18.19,95%CI:11.27,25.12,P<0.001],variations of Jitter[MD=-0.12,95%CI:-0.20,-0.03,P=0.006],variations of Shimmer[MD=-0.51,95%CI:-0.98,-0.05,P=0.03]),the maximum phonation time(MD=2.21,95%CI:0.91,3.51,P<0.001),degree of glottic closure(MD=-0.38,95%CI:-0.48,-0.29,P<0.001),and total hoarseness(MD=-0.13,95%CI:-0.19,-0.07,P<0.001)were significantly improved by an early voice rehabilitation training.Conclusion An early voice rehabilitation training can improve the vocal ability,voice roughness,hoarseness,the maximum phonation time,glottal closure degree and voice impairment in patients with abnormal voice after thyroidectomy.It has a positive effect on vocal cord movement and glottal space closure.

关 键 词：嗓音训练 嗓音康复 甲状腺切除术 嗓音异常 

分 类 号：R473.6[医药卫生—护理学]