术前嗓音训练在声带息肉显微手术患者嗓音恢复中的效果观察

Utility of preoperative voice therapy on the voice recovery of vocal cord polyps patients undergoing the microsurgery

目的:探索术前嗓音训练对声带息肉显微手术患者嗓音恢复的作用。方法:将26例频闪喉镜下诊断为声带息肉,需行支撑喉镜下声带病损切除术的患者随机分为对照组与实验组,每组13例。对照组行手术治疗,实验组除了手术治疗外,在术前1周进行嗓音训练强化课程,对照组和实验组均采用同组人员同种方法进行手术。同时进行术前术后的频闪喉镜评估。采用Ling WAVES声学设备收集、分析同一患者术前24~48h与术后14d的声学参数值(包括不规则度、气息音、总体严重程度、频率微扰、振幅微扰)。使用SPSS 19.0软件进行分析。结果:术前实验组与对照组5项嗓音参数的组间差异无统计学意义,术后实验组气息音与频率微扰明显低于对照组,组间差异具有统计学意义;不规则度、总体严重程度、振幅微扰的组间差异无统计学意义。对照组组内术前与术后比较,患者的总体严重程度与频率微扰在术后明显好于术前,差异有统计学意义;不规则度、气息音、振幅微扰的组间差异无统计学意义。实验组组内术前与术后比较,5项嗓音参数,患者术后都明显好于术前,均差异有统计学意义。实验组和对照组术后的频闪喉镜检查均显示声带息肉切除干净,未见残留。结论:术前嗓音训练有助于显微手术后的嗓音恢复,术前嗓音训练与手术的联合干预是治疗声带息肉的有效方式。

Objective：To evaluate the therapeutic effect on the voice recovery of patients with vocal cord polyps undergoing the microsurgery of preoperative voice therapy.Method：Twenty-six patients diagnosed with unilateral vocal cord polyp under stroboscope,who needed to undergo vocal cord loss resection under supportive laryngoscope,were randomly divided into control group（non-voice training）and treatment group（voice training）,with each group of 13 patients.Patients in control group were just treated with surgical operation.Apart from surgical treatment,patients in treatment group received 6 hours intensive vocal therapy one week before the surgery.The therapy courses consist of the propaganda and education of voice care,postoperative vocal instruction and the patientsself-training under the guidance of voice therapists.The acoustic parameters（irregularity,breathiness,grade,jitter and shimmer）of the same patient were collected 24 to 48 hours before the surgery and14 days after the surgery with Ling WAVES.The results were analyzed with SPSS 19.0.Result：The differences of all the five preoperative voice parameters between control group and treatment group are not significant;but postoperative breathiness and jitter in treatment group were significantly lower than that in control group,while the differences of irregularity,overall severity and shimmer were not significant between control group and treatment group.In control group,breathiness and jitter were significantly improved after surgery,while the differences of irregularity,breathiness and shimmer were not significant between preoperation and postoperation.In treatment group,all the five voice parameters were significantly improved after surgery.According to the laryngostroboscopic examination,the vocal fold polyps were excised completely in both groups.Conclusion：Preoperative voice therapy contributes to the recovery of voice quality of the patients with vocal cord polyps.Combined intervention of surgery and voice therapy is an effective method to treat the patients with vocal cord polyps.