VHI-10在甲状腺术后单侧声带麻痹患者嗓音训练的效度分析

Validity Analysis of VHI-10 In Unilateral Vocal Cord Palsy After Thyroidectomy with Voice Training

目的:分析嗓音障碍指数-10(voice handicap index-10, VHI-10)在甲状腺术后单侧声带麻痹患者嗓音训练的效度。方法:选择45例甲状腺术后单侧声带麻痹患者进行12周嗓音训练,包括气息练习、控制膈肌练习、快速呼吸练习、放松舌根喉部肌肉练习、加强发声练习,运用视觉模拟评分评价其疗效,再根据疗效运用ROC曲线探讨VHI-10的效度分析。结果:根据视觉模拟量表评分后,45例患者中有24例患者经训练后声嘶较前好转,有效率达50.33%。运用ROC曲线分析训练前VHI-10曲线下面积(area under curve, AUC),可得AUC=0.69,最佳峰值VHI-10≥26,说明训练前VHI-10>26,其训练后恢复效果更佳。结论:甲状腺术后单侧声带麻痹患者训练前VHI-10值越高,其恢复效果越明显,尤其是在VHI-10≥26的水平。

Objectives: To analyze the validity of V HI-10 in unilateral vocal cord palsy after thyroidectomy with voice training. Methods: 45 patients were conformed to the diagnostic criterions and conducted 12-weeks voice training, including breath exercise, control diaphragm exercise, rapid breathing exercise, relax the laryngeal and tongue root muscle exercise, and reinforce phonation exercise. The results were concluded by visual analogue scale(VA S) and receiver operating characteristic(ROC) curve was utilized to analyze the validity of V HI-10 before training. Results: A ccording to the values of VA S after voice training, 24 patients realized a better outcome with their voice function, the overall effective rate was 50.33%. The area under curve(A UC) of V HI-10 before training was 0.69, cutoff ≥ 26. The ROC curve demonstrated that the recovery efficacy tends to optimal following by V HI ≥ 26. Conclusions: We found that the more values of V HI-10 were assessed before training in unilateral vocal cord palsy after thyroidectomy, the better improvements of voice function were attained after training, and especially the values were more than 26.