脑卒中吞咽障碍患者嗓音功能及心理状态研究

Voice function and psychological state of stroke patients with dysphagia

目的比较吞咽障碍与吞咽正常的脑卒中患者嗓音功能及心理状态,为制订针对性康复策略提供参考。方法便利选取337例脑卒中患者,通过洼田饮水试验和标准吞咽功能评估分为吞咽障碍组122例与吞咽正常组215例。采用嗓音障碍指数量表、GRBAS法、Praat声学软件进行主、客观嗓音功能评估,采用医院焦虑抑郁量表评估心理状态。结果与吞咽正常组比较,吞咽障碍组GRBAS法中的总嘶哑度、粗糙度、气息度、无力度评分及嗓音障碍指数量表评分、客观声学指标差异有统计学意义(均P<0.05);吞咽障碍组与吞咽正常组焦虑、抑郁评分比较,差异有统计学意义(均P<0.05)。结论脑卒中吞咽障碍患者嗓音功能受损及焦虑抑郁情绪显著高于吞咽正常患者,需开展吞咽-嗓音-心理联合康复。

Objective To compare the voice function and psychological status in post-stroke patients with or without swallowing di-sorders,and to provide a reference for developing targeted rehabilitation strategies.Methods A total of 337 stroke patients were selected by convenance sampling and divided into a dysphagia group(n=122)and a normal swallowing group(n=215)after the Water Swallow Test and Standardized Swallowing Assessment.The Grade,Roughness,Breathiness,Asthenia,and Strain(GRBAS)scale,the Voice Handicap Index-10(VHI-10)and the software Praat were used for subjective and objective voice function assessment,and the Hospital Anxiety and Depression Scale was used to assess the psychological status.Results There were significant differences in the scores of grade,roughness,breathiness,and asthenia,as well as in the VHI-10 score and the objective acoustic indexes between the dysphagia group and the normal swallowing group(all P<0.05).The anxiety and depression scores also had significant differences between the dysphagia group,and the normal swallowing group(all P<0.05).Conclusion Patients with dysphagia after stroke have impaired voice function,and severe anxiety and depression than those with normal swallowing,so swallowing-voice-psychological combined rehabilitation is needed.