不同训练方式和强度对学龄前腭裂术后患儿语音效果影响的初步研究

A preliminary study of different training methods and intensity on speech effect in preschool patients with repaired cleft palate

目的:探讨不同语音训练方式和强度对学龄前腭裂术后患儿语音效果的影响。方法:选取2021年6月~2022年12月于南京市口腔医院就诊的不完全性腭裂术后腭咽闭合完全患儿40例为研究对象,年龄4~6岁,术后首次进行线上(网络)或线下(门诊)语音训练。随机分为2组:A组为线上训练组,B组为线下训练组。每组内再分为低强度(1次/周)和高强度训练组(3次/周)。所有患者均采用音韵治疗改变构音位置的训练方法,0.5 h/次,12次训练为1个疗程,持续2个疗程。采用汉语语音清晰度(speech intelligibility,SI)测试表、代偿性构音(compensatory articulation,CA)表评估语音效果。结果:线上组训练后SI由63.25%提高至91.55%(P<0.001),CA由4.30提高至5.50(P<0.001);线下组训练后SI由63.15%提高至93.05%(P<0.001),CA由4.35提高至5.90(P<0.001)。线下组训练后的SI为93.05%稍高于线上组(91.55%)(P=0.041);CA程度为5.90高于线上组(5.50)(P=0.095)。高强度训练后SI为93.75%,低强度训练后SI为90.85%(P<0.001);高强度训练后CA为6.00,低强度训练后CA为5.40(P=0.01)。结论:线上与线下组训练后的代偿性构音障碍改善程度没有明显差异,线下组训练后的语音清晰度稍好于线上组;增加训练强度可提高语音效果。

Objective:To investigate influence of different training methods and intensity on speech effect in preschool children with repaired cleft palate.Methods:A total of 40 pediatric patients aged 4~6 years old who achieved velopharyngeal competence after primary incomplete cleft palate repair from June 2021 to December 2022 in Nanjing Stomatological Hospital were included in our study.They underwent online or offline(outpatient)speech training after surgery,who were randomly divided into 2 groups:group A(online training group),group B(offline or outpatient training group).Within each group,they were further divided into low-intensity(once per week)and high-intensity training groups(three times per week).All patients underwent a training method of changing the position of articulation using phonological therapy,with a duration of 0.5 hours per session and 12 sessions per course,lasting for 2 sessions.Speech intelligibility(SI)value and compensatory articulation degree(CA)were evaluated to analyze the speech effects of different training methods.Results:After online group training,the SI increased from 63.25% to 91.55%(P<0.001),CA increased from 4.30 to 5.50(P<0.001).After offline group training,the SI increased from 63.15% to 93.05%(P<0.001),and CA increased from 4.35 to 5.90(P<0.001).The SI of the offline group after training was 93.05%,slightly higher than that of the online group at 91.55%(P=0.041)and the degree of CA was 5.90 higher than that of the online group(5.50)(P=0.095).In high-intensity training group,the SI was 93.75%,while the SI was 90.85% in low-intensity training group(P<0.001).After high-intensity training,the CA was 6.00,while after low-intensity training,the CA was 5.40(P=0.01).Conclusion:There was no significant difference in the improvement of compensatory articulation disorders between the online and offline groups after training,while the offline group had slightly better speech clarity than that of the online group.Increasing training intensity can improve speech performance.