嗓音训练在发声不当所致嗓音疾病患者中的疗效

Efficacy of voice training for patients with voice disorders caused by improper vocalization

目的探讨嗓音训练在发声不当所致嗓音疾病患者中的疗效。方法选择110例由于发声方法不当而引起的嗓音疾病患者,根据疾病类型分为声带小结组50例、声带息肉组30例、单侧声带麻痹组30例。所有患者均给予嗓音训练,于嗓音训练前后采用GRBAS评估表、嗓音障碍指数量表、动态喉镜检查、空气动力学检查、计算机嗓音声学分析评价嗓音质量。结果嗓音训练后,声带小结组患者的总嘶哑度和糙声度评分均较嗓音训练前均降低,声带息肉组和单侧声带麻痹组患者的总嘶哑度、糙声度和气息度评分均较嗓音训练前降低(均P<0.05)。3组患者的嗓音障碍指数量表各维度评分和总分,动态喉镜检查的声带闭合、声带运动对称性、声带黏膜波及声带振动规律性评分,以及计算机噪音声学分析的频率微扰、振幅微扰、噪谐比均低于嗓音训练前(均P<0.05)。3组患者空气动力学检查的最大发音时间和最长发音时间均较训练前延长(均P<0.05)。结论嗓音训练对发声不当所致的嗓音疾病患者有良好的治疗效果。

Objective To explore The efficacy of voice training for patients with voice disorders caused by improper vocalization.Methods A total of 110 patients with voice disorders caused by improper vocalization were selected,and they were divided into vocal nodule group(50 cases),vocal cord polyp group(30 cases)and unilateral vocal cord paralysis group(30 cases)according to the disease classification.All patients received voice training.GRBAS evaluation scale,voice handicap index(VHI)scale,and dynamic laryngoscopy,aerodynamic test and computer voice acoustic analysis were used to assess quality of voice before and after voice training.Results After voice training,the overall hoarseness grade and roughness scores of patients in the vocal nodule group were decreased compared with those before voice training,and the overall hoarseness,roughness grade and breathiness scores of patients in the vocal cord polyp group and the unilateral vocal cord paralysis group were lower than those before voice training(all P<0.05).The scores for all dimensions and total score on the voice handicap index scale,scores for vocal cord closure,symmetry of vocal cord motion,vocal cord mucosal wave and vocal cord vibration regularity on dynamic laryngoscopy,as well as scores for frequency jitter,amplitude shimmer and noise-to-harmonic ratio revealed by computer voice acoustic analysis in the three groups were lower than those before voice training(all P<0.05).The maximum loudness phonetic time and the maximum phonetic time in the three groups were prolonged than those before voice training(all P<0.05).Conclusion Voice training has a favorable therapeutic effect on patients with voice disorders caused by improper vocalization.