腭裂后腭裂异常语音治疗周期的研究

Duration of speech therapy in patients with or without velopharyngeal insufficency after palatoplasty

目的 研究腭裂术后腭咽闭合功能不全（velopharyngeal incompetence,VPI）、非VPI型（unvelopharyngeal incompetence,UVPI）腭裂异常语音治疗周期及特点.方法 选取符合语音治疗前后纳入标准的患者188例（男性92例、女性96例,年龄4～ 32岁）,其中腭裂术后VPI 101例、UVPI 87例,统计所有患者完成语音治疗所需训练次数,分析其分布.对UVPI组进行年龄分组观察.VPI组中腭-心-面综合征（velocardiofacial syndrome,VCFS） 39例（SVPI组）,非综合征62例（nonsyndromic velopharynageal incompetence,NSVPI组）,分析不同年龄患者完成语音治疗所需训练次数.结果 以达到汉语各辅音单音节汉字发音清晰为治疗结束,VPI组与UVPI组平均语训次数分别为17、13次,差异有统计学意义（P＜0.05）; SVPI组与NSVPI组平均语训次数分别为19、15次,差异有统计学意义（P＜0.05）;训练次数多集中于16～20、11～15次两区间内.结论 腭裂术后VPI异常语音治疗周期较UVPI长,同时同类患者训练次数差异较大,应制定个性化的治疗方案.

Objective To investigate the duration of speech therapy of patients with or without velopharyngeal insufficency after palatoplasty.nethods One hundred and one cleft-palate patients with velopharyngeal incompetence（VPI） and eighty-seven without VPI were selected in the study.The treatment times of the patients who completed the speech therapy were counted and analyzed. Results The mean treatment frequency in VPI group was 17 times,and in the group without VPI this number was 13（P〈0.05）.In 39 VPI patients with signs of velocardiofaical syndrome, the mean treatment frequency was 19 times, and the mean treatment frequency of the other 62 patents with nonsyndromic VPI was 15 times（P〈0.05）. Conclusions The duration of speech therapy in VPI patients is longger than that in patients without VPI after palatoplasy, but individualized treatment is necessary.