中文版嗓音疲劳指数量表在职业用声者嗓音疲劳评估中的应用

Application of the Chinese version of the vocal fatigue index scale to self-assessment of vocal fatigue of professional voice users

目的探索中文版嗓音疲劳指数量表(VFI)在职业用声者嗓音疲劳(VF)评估中的应用。方法观察组为因嗓音疲劳就诊的职业用声者120例,对患者进行电子喉镜内镜窄带成像技术(NBI)检查,填写中文版VFI量表调查问卷。观察组根据电子喉镜NBI下检查再次分组慢性喉炎组(A组)、声带小结组(B组)、声带肿物组(C组)。对照组为经电子喉镜NBI检查及自我表述无嗓音疾病的职业用声者20例。观察组A组、B组行雾化吸入治疗连续1周,声音休息,口服10 mL蓝芩口服液(3次/d),对症治疗1个月复查,行电子喉镜NBI检查及填写中文版VFI量表。观察组C声带肿物组行声带肿物切除术,标本行病理检查,根据病理结果再次分为良性肿物组(C1组)、恶性肿物组(C2组),术后雾化吸入连续1周,声音休息,口服10 mL蓝芩口服液(3次/d),对症治疗1个月复查。对数据资料进行统计分析。结果①观察组各组及对照组年龄比较,差异无统计学意义(均P>0.05),各组间性别构成比,差异无统计学意义(P=0.8705>0.05);②观察组与对照组相比VFI评分Part1得分、Part2得分均高于对照组,Part3得分低于对照组,差异有统计学意义(P<0.001);③观察组A组与B组,C1组与C2组Part1/2/3得分比较,差异无统计学意义(P=0.125,P=0.492);A组、B组Part1得分均低于C1组,A组、B组Part2得分均低于C1组C2组,A组、B组Part3得分均高于C1组C2组,差异有统计学意义(P<0.05)。A组Part1得分低于C2组,差异有统计学意义(P=0.012)。B组Part1得分低于C2组,差异无统计学意义(P=0.056);④观察组A、B、C1各组经治疗后Part1、Part2VFI评分下降,Part3得分升高,差异有统计学意义(P<0.001)。观察组C2组经治疗后Part1、Part2VFI评分下降,Part3得分升高,差异无统计学意义(P=0.102)。结论中文版VFI量表能够对VF患者发音疲劳和发音回避、发音身体不适以及声音休息与症状的改善三因素提供准确的量化指标,可以用于职业用声者VF主观评估。

Objective To explore the application of the Chinese version of the vocal fatigue index(VFI)to the self-assessment of vocal fatigue in professional voice users.Methods The observation group consisted of 120 professional voice users who were treated in our department due to voice fatigue(VF).The patients were examined using NBI,and they filled the Chinese version of the VFI.According to the findings of NBI examination under electronic laryngoscopy,the observation group was divided into the chronic laryngitis group(group A),vocal cord nodule group(group B),and the vocal cord polyp group(group C).The control group consisted of 20 occupational voice users who were examined using an electronic laryngoscope NBI and self-reported without voice diseases.Observation groups A and B were treated with atomization inhalation for one week,sound rest,10 mL Lanqin oral liquid three times a day,and symptomatic treatment for one month,followed by electronic laryngoscope NBI examination and filling of the Chinese version of the VFI scale.The observation group C underwent vocal cord tumor resection,and the specimens were used for pathological examination.Based on the pathological results,the group was subdivided into the C1 benign tumor group,C2 malignant tumor group,postoperative atomization inhalation for 1 week,sound rest,Lanqin oral liquid 10 mL,three times a day,and symptomatic treatment for 1 month.The results were statistically analyzed.Results 1.The age and sex composition ratios of each of the observation and control groups were compared(P>0.05);the difference was not statistically significant.2.Compared with the control group,the VFI scores of the observation group were higher than those of the control group in Part 1 and Part 2,and lower in Part 3(P<0.001);the difference was statistically significant.3.The scores of group A and group B in Parts 1,2,and 3 and C1 and C2 in the observation group were compared(P=0.125,P=0.492);the difference was not statistically significant.The scores of group A and group B were lower than those in group C1 in Part 1.The scores of group A and group B were lower than those in group C1 and group C2 in part 2.The scores of group A and group B were higher than those in group C1 and group C2 in part 3(P<0.005);the difference was statistically significant.The score of group A was lower than that in group C2 in Part 1(P=0.012),and the difference was statistically significant.The score of group B was lower than that of group C2 in Part 1(P=0.056),and the difference was not statistically significant.4.After treatment,the VFI scores of observation groups A,B,and C1 decreased in Part 1 and Part 2,and the scores of Part 3 increased(P<0.001);the difference was statistically significant.The VFI scores of observation group C2 in Part 1 and Part 2 decreased,and the scores of Part 3 increased(P=0.102);the difference was not statistically significant.Conclusion The Chinese version of the VFI scale can provide accurate quantitative indicators for VF patients in three aspects:pronunciation fatigue and avoidance,pronunciation discomfort,sound rest,and improvement of symptoms.It can be used for the subjective evaluation of the VF of professional voice users.