早期系统发声训练在甲状腺术后声带麻痹患者中的应用效果

Effect of early systematic vocal training on patients with vocal cord paralysis after thyroid surgery

目的探讨早期系统发声训练在甲状腺术后声带麻痹患者中的应用效果。方法抽取2021年5月至2022年4月郑州大学第一附属医院收治的甲状腺术后声带麻痹患者78例,按随机数字表法分为对照组和观察组,每组39例。对照组采用常规发声训练,观察组在对照组基础上采用早期系统发声训练。比较两组恢复优良率、干预前后嗓音质量[嗓音障碍指数-10(VHI-10)评分、主观听感知评估参数(sGRBAS)评分]、声学检测参数(基频微扰、振幅微扰)、空气动力学指标[最长发音时间(MPT)、最大发音时间(MLPT)、平均气流率(MFR)]、动态喉镜指标(声带闭合、声带振动规律性评分)水平。结果观察组恢复优良率(84.62%,33/39)高于对照组(61.54%,24/39),P<0.05。干预后,观察组VHI-10、GRBAS评分低于对照组(P<0.05);观察组基频微扰、振幅微扰低于对照组(P<0.05);观察组MPT、MLPT水平高于对照组,MFR水平低于对照组(P<0.05);观察组声带闭合、声带振动规律性评分低于对照组(P<0.05)。结论早期系统发声训练应用于甲状腺术后声带麻痹患者中,能提升嗓音质量,改善声学检测参数及空气动力学指标,调节声带闭合和声带振动,恢复患者嗓音功能。

Objective To investigate the effect of early systematic vocal training on patients with vocal cord paralysis after thyroid surgery.Methods A total of 78 patients with vocal cord paralysis after thyroid surgery in the First Affiliated Hospital of Zhengzhou University from May 2021 to April 2022 were selected,and they were divided into control group and observation group according to random number table method,with 39 cases in each group.The control group received routine vocal training,and the observation group received early systematic vocal training based on the treatment of the control group.The recovery excellent rate and the levels of voice quality assessed by voice handicap index-10(VHI-10)score and subjective auditory perception evaluation parameters(GRBAS)score,acoustic detection parameters,including fundamental frequency perturbations and amplitude perturbations,aerodynamic indicators,including maximum pronunciation time(MPT),maximum loudness phonation time(MLPT)and mean flow rate(MFR),dynamic laryngoscopy indicators(vocal cord closure,vocal cord vibration regularity score)were compared between the two groups before and after intervention.Results The recovery rate of the observation group(84.62%,33/39)was higher than that of the control group(61.54%,24/39),P<0.05.After intervention,the VHI-10 score and GRBAS score of the observation group were lower than those of the control group(P<0.05);the fundamental frequency perturbations and amplitude perturbations of the observation group were lower than those of the control group(P<0.05);the levels of MPT and MLPT of the observation group were higher than those of the control group,and the MFR level of the observation group was lower than that of the control group(P<0.05);the scores of vocal cord closure and vocal cord vibration regularity in the observation group were lower than those in the control group(P<0.05).Conclusions Early systematic vocal training on patients with vocal cord paralysis after thyroid surgery can improve voice quality,improve acoustic detection parameters,andaerodynamic indexes,adjust vocal cord closure and vibration,and restore voice function.