环杓关节拨动联合嗓音矫治治疗环杓关节脱位的疗效分析

Curative Effect of Arytenoid Joint Manipulation Combined with Voice Therapy in the Treatment of Arytenoid Dislocation

目的探讨环杓关节拨动联合嗓音矫治治疗环杓关节脱位的疗效,为环杓关节脱位的治疗提供参考。方法选取31例明确诊断为单侧环杓关节脱位的患者,将其分为环杓关节拨动组(12例,采用环杓关节拨动治疗)和环杓关节拨动联合嗓音矫治组(19例,采用环杓关节拨动联合嗓音矫治),对两组患者治疗前后进行嗓音声学分析、空气动力学检测及简化嗓音障碍指数量表(VHI-10)评估,比较两组结果。结果治疗前两组间嗓音声学分析指标(F0、jitter、shimmer、NHR)差异无统计学意义(P>0.05),治疗后各项指标均较矫治前降低(P<0.05),且环杓关节拨动联合嗓音矫治组下降更明显,与环杓关节拨动组比较差异有统计学意义(P<0.05);两组治疗前空气动力学各项指标差异无统计学意义(P>0.05),治疗后两组最长发声时间(MPT)、声门下压(SGP)升高、声门阻力(GR)升高、平均气流率(MFR)降低,发声效率(VE)提高且环杓关节拨动联合嗓音矫治组改善更明显,两组比较各项指标差异均有统计学意义(P<0.05);治疗前两组VHI-10得分差异无统计学意义(P>0.05),治疗后两组VHI-10得分均降低(P<0.05),且治疗后环杓关节拨动联合嗓音矫治组VHI-10得分较环杓关节拨动组降低更明显(P<0.05)。结论环杓关节拨动联合嗓音矫治治疗环杓关节脱位较单独环杓关节拨动术效果明显。

Objective To investigate the effect of arytenoid stirring combined with voice therapy on the treatment of arytenoid dislocation.Methods A total of 31 patients with unilateral arytenoid dislocation were selected as subjects.They were divided into two groups:the arytenoid stirring group(12 patients)and the voice therapy combined group(19 patients).The parameters measured before and after were for voice therapy:F 0,jitter,shimmer,NHR,MPT,SGP,GR,MFR and VE.The results of the simplified vocal dysfunction index table(VHI-10)before and after the voice therapy were analyzed.Results An acoustic analysis of the two groups before the treatment showed that:F 0,jitter,shimmer,NHR were reduced after voice therapy.For the aerodynamic parameters,MPT,SGP and GR were increased,but MFR was reduced.VE was improved and VHI-10 score reduced.The differences were statistically significant(P<0.05).Compared with the arytenoid stirring group,the values of the voice therapy combined group were more significant,and the difference was statistically significant(P<0.05).Conclusion The arytenoid stirring combined with voice therapy is more effective than arytenoid stirring only in the treatment of arytenoid dislocation.