嗓音训练治疗声门闭合不全所致功能性嗓音障碍的疗效分析

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1、屮国耳鼻咽喉颅底外科杂志2017,05(23),422-426DOI:10.11798/j.issn.l007-1520.201705006嗓音训练治疗声门闭合不全所致功能性嗓音障碍的疗效分析黄前进李兆生许振跃福建医科大学附属漳州市医院耳鼻咽喉科导出/参考文献关注分享收藏打印摘要：目的探讨嗓咅训练对声门闭合不全的功能性嗓咅障碍患者的疗效。方法对24例声门闭合不全的功能性嗓音障碍患者进行8周的嗓音训练，训练内容包括健康宣教、肌肉放松、喉部按摩、暖嗓、呼吸训练、嗓音训练和共鸣训练，训练前后对患者进行电子喉镜检查、GRBAS评估、嗓音障碍指数量表(VHI)评估、计算机嗓音声学分析，比较训练前后评估

2、结果。结果24例患者训练后电子喉镜检查16例患者声门闭合良好(66.67%，16/24),6例声门裂隙变小(25.00%，6/24)，2例声门裂隙无明显变化(8.33%，2/24);GRBAS评分屮总嘶哑度G(0.61±0.66)明显低于训练前(1.91±0.87)(1X0.05),粗糙声R(0.51±0.58)明显低于训练前(1.41±0.52)(P〈0.05);VHI评分总分(29.21±21.02)分明显低于训练前的(52.35±23.45)分(P〈0.05);计算机嗓音声学分析最长发声时间(15.24±3.64)s比训练前(9.02±3.45)s明显延长(P〈0.05)，棊频微扰、最

3、高基频、最低音强、嗓音障碍严重指数训练后分别为(0.21±0.08)%、(420.11土44.21)Hz、(54.21±3.20)dB、(1.62±0.82)比训练前的(0.92±0.12)%、(375.21±49.21)Hz、(56.81土3.42)dB、(0.21±1.02)有改善(P<0.05)。结论嗓音训练能改善声门闭合不全的功能性嗓音障碍患者的声门闭合及嗓音质量。关键词：声门闭合不仝;嗓音训练;嗓音障碍指数量表;嗓音障碍严重指数;作者简介：黄前进，男，主治医师。Emaik245019329@qq.com收稿日期：2017-03-17Effectofvoicetrainingforf

4、unctionalvoicedisorderinpatientswithglottaldysraphismHUANGQian-jinLIZhao-shengXUZheng-yueDepartmentofOtolaryngology，ZhangzhouMunicipalHospitalAffiliatedtoFujianMedicalUniversity;Abstract：ObjectiveToinvestigatetheeffectivenessofvoicetrainingforfunctionalvoicedisorderinpatientswithglottaldysraphism.M

5、ethodsTwenty-fourpatientssufferingfromfunctionalvoicedisorderwithglottaldysraphismwentthrougha8-weekvoicetraining.Thetrainingprogramincludedhealtheducation,musclerelaxation,laryngealmassage,warmvoice,breathingtraining，voicetrainingandresonancetraining.Electroniclaryngoscopy,GRBASevaluation,voicehan

6、dicapindex(VHI)andcomputervoiceacousticanalysiswereperformedbeforeandafterthetrainingprocedureinallthepatients,andtheresultswerecompared.ResultsAfterthevoicetraining,electroniclaryngoscopyrevealedcompleteclosureofglottisin16patients(66.67%,16/24)，smallerglotticfissurein6(25.00%,6/24)，andunchangedgl

7、otticfissurein2(8.33%,2/24).AsfortheGRABSevaluation,thescalesofgrade(G)(0.61土0.66)androughness(R)(0.51土0.58)aftertrainingwerelowerthanthose(1.91土0.87)(1.41土0.52)beforetrainingrespectively,andthedifferencesw