声带良性病变患者声门下压的变化特点研究

The Characteristics of the Changes in Subglottal Pressure in Patients with Vocal Folds Lesions

目的观察分析声带良性病变患者声门下压的特点及术后改变。方法对30例正常者与200例声带良性病变(声带息肉、声带囊肿、声带任克水肿、声带小结、声带沟、声带麻痹、慢性肥厚性喉炎)患者的声门下压进行对比分析,并对患者术后声门下压的变化特点进行分析。结果声带病变患者声门下压较正常者高且除声带小结外差异均具有统计学意义(F=33.067,P<0.05),其中声带任克水肿、声带麻痹患者声门下压最高,其次为声带息肉、声带囊肿、声带沟、慢性肥厚性喉炎。声带良性病变患者术后声门下压均较术前明显减低,差异具有统计学意义(任克水肿P=0.000,声带息肉P=0.012,声带囊肿P=0.000,声带沟P=0.000,声带麻痹P=0.000)。但声带任克水肿、声带沟、声带麻痹患者术后声门下压仍然高于正常,声带息肉、声带囊肿术后声门下压与正常者无显著性差异。结论声带良性病变声门下压力均有不同程度升高,声带病变手术后声门下压有不同程度改善,声门下压可以作为评价病变严重程度及手术效果的客观依据,同时为康复治疗提供参考。

Objective The purpose of this study was to observe and analyze the characteristics and changes of subglottal pressure （SGP） before and after operation in patients with vocal folds lesions. Methods Voice samples from 30 healthy subjects and 200 patients with vocal folds lesions （Vocal polyp,Vocal cyst,Reinke＇s edema.Vocal folds nodules,Voxal folds sulcus,Vocal folds paralysis and chronic nypertrophic Larynyitic）were recorded under normal conditions of pitch and intensity. Results The SGP of patients with vocal folds lesions was clearly higher than that of the normal controls; the difference was statistically significant for all lesion types except vocal folds nodules. Among the lesions, the SGP of patients with either Reinke＇s edema or vocal folds paralysis was the highest, followed by vocal polyp, vocal cyst, vocal folds sulcus and chronic hypertrophic laryngitis. The SGP of patients with vocal nodules was the lowest. The postoperative SGP of patients with vocal folds disease was clearly reduced compared with the preoperative pressure, and the difference was statistically significant; however, the SGP of patients with Reinke＇s edema, vocal folds sulcus, and vocal folds paralysis was still higher than that of the controls, and the differences in postoperative SGP between patients with vocal folds polyps or cysts and the normal controls were not significant. Conclusion SGP could be recognized as an objective index in clinical diagnosis of vocal folds diseases and the judgment basis of operation effect. It could also provide a reference for rehabilitation treatment.