女性声带息肉术后发声功能恢复的时间观察

Recovery time of phonation function in female patients after vocal polyp surgery

目的探讨声带息肉术后发声功能恢复的时间及规律。方法对51例声带息肉患者(患者组)分别于支撑喉镜术后1、2周及1、3、6个月进行嗓音声学指标基频(fundamental frequecy,F0)、基频微扰(jitter)、振幅微扰(shimmer)、噪/谐比(noise to harmonic ratio,NHR)及嗓音障碍指数(voice handicap index,VHI)调查,对51例嗓音正常人(正常对照组)进行嗓音学分析及VHI调查,对比分析术后嗓音恢复情况。结果患者组F0较正常对照组降低,jitter、shimmer、NHR较正常对照组升高,差异有统计学意义(P<0.05);随着时间的推移,患者组F0逐渐升高,其余4个指标均有一定程度的降低,其中F0、jitter、shimmer、NHR在第1个月接近正常对照组,且与3、6个月时差异无统计学意义(P>0.05),VHI评分在3、6个月时与正常对照组相近,且差异无统计学意义(P>0.05)。结论声带息肉患者支撑喉镜术后嗓音质量逐渐恢复,术后1周内禁声休息,1个月内休声,1个月以后可正常、正确用嗓。

Objective To study the polyps patients after surgery. Methods The vocal cords polyps （patient group） treated by recovery time and pattern of phonation function in the vocal voice acoustic analysis was conducted on female patients with suspension laryngoscopy in our department from April 2014 to June 2015, and matched healthy people with normal cords （control group）, with 51 cases in each group. Parameters including fundamental frequency （F0）, jitter, shimmer, noise to harmonic ratio （NHR） and voice handicap index （VHI） were examined at weeks 1 and 2, months 1, 3 and 6 after surgery. Data were comparatively analyzed between the 2 groups for observation of the vocal rehabilitation. Results Compared to control group, the patient group had lower F0 and higher jitter, shimmer and NHR, and the differences were statistically significant （ P 〈 0. 05 ）. FO was gradually increased along with the recovery time, but higher jitter, shimmer and NHR were measurably decreased. At the 1 st month the 4 parameters were closed to the levels of control group, and no significant difference was found at the 3rd and 6th months （P 〉 0. 05 ）. For VHI grades, they were approached to control group at the 3rd and 6th months without statistical difference （P 〉 0.05）. Conclusion The recovery of vocal function in patients with vocal cords polyps after microflap surgery is stepwise, and becomes normal after 1 month. Hence, we recommend the patients not to speak within the 1 st week and rest their voice for 1 month after surgery.