嗓音障碍严重指数在咽喉反流相关嗓音疾病中的应用研究

Application of dysphonia severity index in laryngeal reflux related voice diseases

目的:探讨嗓音障碍严重指数(DSI)在咽喉反流(LPR)相关嗓音疾病诊疗评价中的有效性和可靠性。方法:选取2016-01-2017-06期间就诊的嗓音疾病伴有LPR并确诊的患者54例,根据是否接受手术治疗分为手术组和非手术组。手术组(32例)接受激光手术和规范抑酸治疗6周;非手术组(22例)接受规范抑酸治疗6周。治疗前后分别进行24h多通道腔内阻抗-pH监测、反流症状指数评分(RSI)、反流体征指数评分(RFS)、主观听感知评估和嗓音客观声学参数检测并计算嗓音障碍严重指数进行分析。结果:2组患者年龄、性别和病程均差异无统计学意义(P>0.05);与治疗前比较,2组治疗后RSI、RFS、Jitter、Shimmer、G值和R值明显降低(P<0.05),MPT和DSI明显升高(P<0.05);手术组在治疗前RSI、RFS、Jitter、Shimmer、G值和R值明显高于非手术组(P<0.05),MPT和DSI值明显低于非手术组(P<0.05);2组治疗后各项参数差异无统计学意义(P>0.05);DSI与Jitter、Shimmer、G值、R值呈负相关(P<0.01);与RSI、RFS、MPT呈正相关(P<0.01);与病变部位有关(P<0.05)。结论:DSI可以作为对LPR相关嗓音疾病的诊断和治疗效果进行客观评价的指标,准确可靠。

Objective：To discuss the validity and reliability of dysphonia severity index in evaluating the effect of diagnosis and treatment of laryngeal reflux related voice diseases.Method：54 cases of voice disease patients accompanied by laryngopharyngeal reflux from January 2016 to June 2017 in department of otorhinolaryngology of our hospital were divided into two groups according to treatment type.32 cases in the operation group received laser surgery and standard acid suppression therapy for 6 weeks,and 22 patients in the non-operation group received standard acid suppression therapy for 6 weeks.24 hmultichannel impedance pH（MCII-pH）monitoring was carried out.The indexes of reflux symptom,reflux finding score,subjective auditory perception and objective acoustic parameters of voice were measured before and after treatment,and the dysphonia severity index was calculated and analysed.Result：There was no significant difference in age,sex and course of disease between the two groups（P0.05）.Compared with pre-treatment,RSI,RFS,Jitter,Shimmer,G and R in two groups decreased significantly after treatment,and MPT,DSI increased significantly（P0.05）.Before treatment,RSI,RFS,Jitter,Shimmer,G and R in the operation group were significantly higher than those in the non-operation group,and MPT,DSI were lower（P0.05）.There were no significant differences in the parameters between the two groups after treatment（P0.05）.DSI was negatively correlated with GRBAS scoring parameters,Jitter and Shimmer,and positively correlated with RSI,RFS,and MPT（P0.01）.DSI is related to the location of the lesion（P0.05）.Conclusion：DSI can be used as an objective evaluation index for the diagnosis and treatment of laryngeal reflux related voice diseases,and it is accurate and reliable.