单侧小声带息肉患者术后声休时间对嗓音功能的影响
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山西医科大学第一医院耳鼻咽喉头颈外科

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山西省基础研究计划自然科学“Has_circ_0075961促进喉鳞状细胞癌细胞侵袭转移的机制研究”(项目编号:No:20210302123250);山西医科大学博士启动基金资助项目“ZEB1对喉鳞癌EMT的调控及Hep-2细胞功能的影响”(项目编号:No:03201628);山西医科大学第一医院136专项经费科研项目“发声障碍患者嗓音训练疗效观察及主客观分析的应用”(项目编号:2021052923)。


Effect of postoperative voice rest time on voice function in patients with unilateral small polyp of cord
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Department of Otorhinolaryngology Head and Neck Surgery,the First Hospital of Shanxi Medical University

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    摘要:

    目的 探讨单侧小声带息肉患者术后声休时间对嗓音功能的影响。方法 筛选山西医科大学第一医院耳鼻咽喉头颈外科住院部中拟行单侧小声带息肉手术的患者120例,术前予以嗓音卫生宣教,指导患者发声方法训练,并完善相关嗓音声学分析,包括基频微扰(Jitter)、振幅微扰(Shimmer)、最长发声时间(MPT)、嗓音障碍严重指数(DSI)、粗糙声,气息声,嘶哑声(RBH)、嗓音障碍指数量表(VHI)等,术后采用随机抽样法将患者分为3组,每组40例(A组:术后声休3日组,B组:术后声休7日组,C组:术后声休2周组),各组患者术前各嗓音声学参数均无统计学差异,3组患者在常规治疗(健康教育、手术治疗、药物治疗)的基础上分别术后绝对声休3日、7日、2周,声休结束后予以8周的嗓音训练,于术后3月、6月复查时行嗓音声学分析,分析各组间嗓音声学参数的差异性,并与术前各嗓音声学参数进行对比。结果 1.术后3个月、6个月,各分组嗓音训练后Jitter、Shimmer、VHI、RBH均明显下降,MPT、DSI明显上升,与术前相比差异有统计学意义(P<0.05);2.术后3月,A组和B组的Jitter、Shimmer、MPT、RBH、DSI、VHI值差异有统计学意义(P<0.05),A组和C组的RBH、MPT、DSI、VHI值差异有统计学意义(P<0.05),B组和C组的DSI、VHI值差异有统计学意义(P<0.05),其余各项指标均无统计学差异(P>0.05);3.术后6月,A组和B组的Jitter、Shimmer、MPT、RBH、DSI、VHI值差异有统计学意义(P<0.05),A组和C组的Shimmer、RBH、MPT、DSI、VHI值差异有统计学意义(P<0.05),B组和C组的DSI、VHI值差异有统计学意义(P<0.05),其余各项指标均无统计学差异(P>0.05)。结论 1.单侧小声带息肉患者在常规治疗的基础上,声休结合嗓音训练均可改善患者的嗓音质量;2.单侧小声带息肉患者术后声休3日,这样更有利于声带创面的愈合和发声功能的恢复。

    Abstract:

    Objective To explore the effect of postoperative voice rest time on voice function in patients with unilateral small polyp of cord.Method A selection of 120 patients proposed to undergo unilateral small polyp of cord surgery in the inpatient department of Otolaryngology, Head and Neck Surgery Department of the First Hospital of Shanxi Medical University, Voice hygiene education before surgery, To guide patients in vocal method training, And improve collect the relevant voice acoustic analysis, Including Fundamental frequency Perturbation(Jitter),Fundamental frequency Perturbation(Shimmer),Maximum Phonation Time( MPT),Dysphonia Severity Index( DSI),Roughness,Breathiness,Hoarseness(RBH),Voice Handicap Index(VHI)etc., After random sampling, patients were divided into 3 groups,there were 40 cases in each group (Group A: Group 3 days of postoperative voice rest, Group B: 7 days, Group C: 2 weeks), There were no statistical differences in the preoperative vocal acoustic parameters in each group.Three subgroups of patients had absolute postoperative voice rest that took 3 days, 7 days, and 2 weeks on the basis of routine treatment (health education, surgical treatment, and medical treatment), respectively, Eight weeks of voice training after the voice break, Voice acoustic analysis was performed in 3,6 month after operation, Analyanalyze the differences in vocal acoustic parameters between groups, And compared with the preoperative voice acoustic parameters.Results 1. 1 month, 3 months, and 6 months after surgery, In Jitter, Shimmer, VHI and RBH all decreased significantly after voice training in each group, The MPT, DSI increased significantly, There was significant compared with preoperative difference (P <0.05); 2. In 3 months after surgery, The Jitter, Shimmer, MPT, RBH, DSI, and VHI values varied significantly between groups A and B (P <0.05), The RBH, MPT, DSI, and VHI values varied significantly between groups A and C (P <0.05), The DSI values and VHI values varied significantly between groups B and C (P <0.05), The other indicators were not statistically different (P> 0.05); 3. In 6 months after surgery, The Jitter, Shimmer, MPT, RBH, DSI, and VHI values varied significantly between groups A and B (P <0.05), The Shimmer, RBH, MPT, DSI, and VHI values varied significantly between groups A and C (P <0.05), The DSI values and VHI values varied significantly between groups B and C (P <0.05), None of the other indicators were statistically different (P> 0.05).Conclusion 1. On the basis of routine treatment,sound rest combined with voice training can improve the voice quality of patients; 2. Patients with unilateral voice polyp can take 3 days after surgery, which is more conducive to the healing of vocal cord wound and the recovery of vocal function.

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  • 收稿日期:2022-10-08
  • 最后修改日期:2022-11-10
  • 录用日期:2022-11-15
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