成人不良发声行为性嗓音疾病患者嗓音障碍分析及矫治策略

Analysis of the Voice Dysphonia Due to Unhealthy Phonation and the Therapeutic Strategies of the Voice Dysphonia

目的对不良发声行为性嗓音疾病进行系统的嗓音障碍分析,寻找一种合适的矫治方法。方法对150例不良发声行为性嗓音疾病患者和98例正常对照组患者进行主观评估和客观评估,找到它们发音障碍的特点,以进行针对性的发声矫治。结果在主观评估中,两组患者嗓音自测表结果和GRBAS评估结果明显差异有统计学意义(P<0.05)。两组在响度自我评价中差异无统计学意义。在客观评估中,嗓音分析结果显示,两组在平均言语基频、基频标准差、基频微扰、振幅微扰、S/Z、MPT方面差异有统计学意义(P<0.05)。声门噪声能量、谐噪比差异无统计学意义;电声门图结果显示,两组在接触幂、开放率、闭合率方面差异有统计学意义(P<0.05);两组在接触率、接触率微扰和接触幂微扰方面差异无统计学意义;不良发声障碍嗓音疾病患者嗓音障碍类型以音质异常最多,占95.33%,其次为呼吸支持不足占88.00%。结论成人不良发声行为嗓音疾病嗓音障碍为多为复合型发声障碍,制定以纠正呼吸障碍为基础,矫正患者的发声障碍和共鸣障碍为重点,进一步改变患者的起音方式的矫治策略。

Objective To analyze the voice dysphonia due to unhealthy phonation and find a suitable method of the vocal correction.Methods The 150 cases with the voice dysphonia due to unhealthy phonation and 98 cases of healthy controls were tested by the subjective assessment and objective assessment,to find the targeted vocal treatment.Results In the subjective assessment,the diference of the self-rated table and GRBAS assessment of the two groups was statistical significance（P 0.05）.But there was no statistical significance in the self-rated loudness of two groups.In the subjective assessment,the results of the voice acoustic analysis showed that there was statistical significance in the results of the fundamental frequency,fundamental frequency standard deviation,jitter,shimmer,S/Z ration and the maximum phonation time（P 0.05）.But the result of the normalized noise energy and harmonic-to-noise ration of the two groups was of no statistical significance.The electrottography showed that there was statistical significance in the result of the contact interface,the closur rate and the open rate（P 0.05）.But there was no significance difference in contract quotiety,contact quotiety perturbation and contract interface perturbation between the two groups.The most type of voice dysphonia due to unhealthy phonation was the dystimbria,accounting for 95.33%,and followed by respiratory support,accounting for 88.00%.Conclusion The voice dysphonia due to unhealthy phonation was complex dysphonia,formulated on the basis of correct breathing disorder,corrected the patients with voice disorders and resonance disorders,further changed the sound way of treatment for patients.