腭裂咽成形术后患者异常语音的发音特点研究

The study on articulation characteristics of the patients after pharyngoplasty

目的:对腭裂咽成形术后患者的发音特点和发生机制进行探讨。方法:本组病例82例(男46,女36),年龄4～31岁(平均13.44岁)。采用汉语语音清晰度测试表(包含音节、词、词组、短句)对患者录音,并对其语音清晰度、异常语音、代偿性发音进行分析比较。结果:在82例患者中,以腭咽闭合不全型为特点的代偿性语音71例:声门塞音60例、咽摩擦音11例;以腭咽闭合良好型为特点的代偿性语音11例:腭化音6例、腭化+侧化音2例、侧化音3例。清晰度:声门塞音46.27%、咽摩擦音57.19%、腭化音67.17%、腭化+侧化音74.67%、侧化音77.50%。异常辅音多见于塞音、擦音、塞擦音,辅音的弱化以送气音p66.67%(8/12)、t78.95%(15/19)、s60%(39/64)、sh60%(39/64)、c66%(43/65)、ch66%(43/65)、x62%(39/63)、q67%(43/64)、k76%(31/41)、b73%(43/59)所占比例较多;辅音的脱落则以不送气音z81%(56/69)、zh81%(56/69)、j80%(56/70)、g84%(48/57)所占比例较多。结论:咽成形术后仍以腭咽闭合不全型为特点的代偿性语音为主,主要表现为辅音的脱落与弱化。产生弱化的辅音多见于送气音,产生脱落的辅音则多见于不送气音。

PURPOSE: The purpose of this study was to investigate the articulation characteristics and mechanism of the patients after pharyngoplasty. METHODS: 46 males and 36 females with the average age of 13.44 years (ranged from 4 years to 31 years) were included. The patients' articulation including syllables, words, phrases and sentences was recorded according to Chinese Speech Intelligibility Testing Form, and a comparison among speech articulation, speech disorders and compensatory articulation was carried out. RESULTS: 71 patients had compensatory articulation characteristic of velopharyngeal incompetence, of them, 60 occurred in glottis plosive and 11 in pharynx fricative; while 11 patients had compensatory articulation characteristic of velopharyngeal adequacy, of them, 6 occurred in palatalized misarticulation, 2 in palatalized and lateral misarticulation,3 in lateral misarticulation.According to speech intelligibility 46.27% of misarticulation was glottis plosive, while 57.19% was pharynx fricative, 67.17% was palatalized misarticulation, 74.67% was palatalized and lateral misarticulation, 77.50% was lateral misarticulation. According to the degree of pharynx fricative, 45.45%(5/11) was mild, 27.27%(3/11) was moderate and 27.27%(3/11) was severe. Abnormal consonant mainly occurred in plosive, fricative and affricative. The attenuation of consonant mainly occurred in p (66.67%,4/12), t(78.95%,15/19),s(60.94%,39/64), sh(60.94%,39/64), c(66.15%,43/65), ch(66.15%,43/65), x(61.90%,39/63), q(67.19%,43/64), k(75.60%,31/41), b(72.88%,43/59); While the disappearance of consonant mainly occurred in z(81.16%,56/69), zh(81.16%,56/69), j(80%,56/70),and g (84.21%,48/57). CONCLUSIONS: The compensatory articulation resulting from velopharyngeal incompetence after pharyngoplasty mainly occurred in attenuation and disappearance of consonant.The attenuation of consonant mainly occurred in aspirated syllables and the disappearance of consonant mainly occurred in non-aspirated syllables.