言语训练联合蒙特梭利教育对腭咽闭合不全术后患儿语音问题的疗效分析  

Efficacy of Speech Training Combined with Montessori Education on Speech Problems in Children after Velopharyngeal Insufficiency Surgery

作　　者：姚琬雁 李明娣[2] 梁冠军[2] 顾琴[2] 张何威[2] 苏敏[1] Yao Wanyan;Li Mingdi;Liang Guanjun;Gu Qin;Zhang Hewei;Su Min(Department of Rehabilitation Medicine,Dushu Lake Hospital Affiliated to Soochow University,Suzhou,215128,China;Children's Hospital of Soochow University;不详)

机构地区：[1]苏州大学附属独墅湖医院康复医学科,苏州215128 [2]苏州大学附属儿童医院康复科

出　　处：《听力学及言语疾病杂志》2024年第5期432-436,共5页Journal of Audiology and Speech Pathology

基　　金：苏州市民生科技项目(SYSD2020209)。

摘　　要：目的分析言语训练联合蒙特梭利教育改善腭咽闭合不全术后儿童语音问题的效果。方法回顾分析2019年1月至2021年12月于苏州大学附属儿童医院行腭咽修复术的63例患者资料,将其分为三组,术后定期门诊随访行家庭康复训练的21例患者为对照组A组,B组21例在医院规律地行常规言语训练,C组21例患者在B组基础上开展蒙特梭利教育。使用构音清晰度评估三组治疗前、治疗6个月后的构音清晰度改善情况,使用鼻腔共鸣状况评估和拍摄发/i/音时的头颅定位侧位X线片比较B组与C组鼻腔共鸣状况和腭咽闭合功能的改善情况。结果康复训练6个月后,三组构音清晰度均得到提高,A组提高35.45%,B组提高43.66%,C组提高49.33%,差异有统计学意义(P<0.05)。B、C两组的鼻音改善率达100%,其中B组鼻音消除率为70.00%,C组的鼻音消除率为95.24%,差异有统计学意义(P<0.05)。在发/i/音时,B组7例患者存在腭咽闭合不全,C组仅1例患者存在腭咽闭合不全情况,两组发音状态下的腭咽功能疗效具有统计学无异(P<0.05)。结论腭咽闭合不全患者术后进行针对性语音训练是有必要的,言语训练与蒙特梭利教育相结合,能明显提高腭咽闭合功能,从而尽早获得良好的鼻腔共鸣状态和正确的发音。Objective To study the efficacy of speech training combined with Montessori education on speech problems in children after velopharyngeal insufficiency surgery.Methods A retrospective analysis of 63 cases of children who underwent velopharyngeal repair at Children's Hospital of Soochow University between January 2019 and December 2021 was conducted.Subjects were divided into three groups.A total of 21 patients who received family rehabilitation training after the operation were divided into control group A,42 patients who received regular hospital rehabilitation training after the operation were divided into group B and group C,of which 21 patients in group B received routine speech training,and 21 patients in group C received Montessori education and routine speech training.Nasal resonance status,assessment of dysarthric intelligibility,and cranially positioned lateral radiographs when pronouncing/i/sounds were evaluated individually before treatment and 6 months after treatment.The improvement of velopharyngeal function,nasal resonance status,and dysarthric articulation were evaluated.Results After the six-month intervention,the dysarthric speech intelligibility were significantly improved in three groups with improvement of 35.45%in group A,43.66%in group B,and 49.33%in group C,respectively(P<0.05).The improvement rate of nasality reached 100%in the B and C group with nasality elimination rate of 70%in group B and 95.24%nasality elimination in group C,and the efficacy of the two groups was statistically significant(P<0.05).During phonation of the/i/tone,velopharyngeal insufficiency was observed in seven patients in group B and in only one patient in group C,and the efficacy was statistically significant in both groups(P<0.05).Conclusion Postoperative targeted speech training is necessary in patients with velopharyngeal insufficiency,and speech training combined with Montessori education can significantly improve the function of velopharyngeal closure,thus achieving a good state of nasal resonance and correct a

关 键 词：腭咽闭合功能 蒙特梭利教育 高鼻音 构音清晰度 言语训练 

分 类 号：H01[语言文字—语言学]