腭裂术后患者舌尖音构音异常的语音特点及语音训练

发布时间：2018-07-07 20:40

本文选题：腭裂 + 舌尖音　；参考：《郑州大学》2016年硕士论文

【摘要】：腭裂患者手术后虽建立了正常的腭咽闭合解剖结构,但如果不进行语音训练,软腭的活动度依然很差,仍然会存在不良的发音习惯,从而无法获得正常的语音,使患者与人的沟通交流产生障碍,对其学习、生活及工作造成了不利影响,进而使患者产生严重的自卑心理,使其不能融入正常的社会生活。本研究分析了腭裂术后舌尖音异常患者舌尖音的临床发音特点及声学特征,为给患者制定个性化的、有效的语音训练方案提供依据;通过语音训练方法的探究,为临床中更好地开展腭裂术后患者的语音训练提供参考。目的分析腭裂术后腭咽闭合功能完全和轻度腭咽闭合不全的患者舌尖音异常的语音特点,并探讨两类患者语音训练的方法,为临床中进行患者的语音训练提供指导依据。方法收集2012年7月~2014年12月于郑州大学第一附属医院语音治疗科就诊的腭裂术后舌尖音异常的四岁以上的患者220例,其中男117例,女103例,男女比例为1.1:1,年龄4~25岁,平均年龄为(10.89±8.65)岁。分别采用CSL按照华西口腔医院语音清晰度测试表对220例患者进行舌尖音异常语音的检测,分析患者舌尖音构音障碍的临床特点。对符合入选标准的42例患者按照汉语语音清晰度测试表分别在舌尖音训练前和训练后进行录音,并计算训练前后患者舌尖音错误的个数,采用SPSS17.0统计软件进行统计学处理,本研究的实验设计类型为自身配对设计,对舌尖音语音训练的效果进行配对t检验,检验水准α=0.05。结果腭裂术后腭咽闭合完全的患者有108例、腭咽闭合不全的患者112例;108例腭咽闭合完全的患者中舌尖音发生置换、脱落、舌后音化和侧化的患者分别有89例、52例、19例和12例,所占比例分别为82.4%、48.1%、17.6%和11.1%;112例轻度腭咽闭合不全的患者舌尖音异常的特点主要表现为/i/音和/u/音的鼻音构音,/zh/、/ch/、/sh/、/z/、/c/、/s/的浊化代偿,/l/音的浊化代偿,/d/音脱落,/t/音脱落和/zh/、/ch/、/sh/、/z/、/c/、/s/的侧化,所占比例分别为59.8%(67例)、59.8%(67例)、50.0%(56例)、40.2%(45例)、25%(28例)、19.6%(22例)。腭裂术后腭咽闭合完全和轻度腭咽闭合不全的患者经过舌尖音的语音训练后,舌尖音错误个数分别减少了(22.19±8.98)和(22.24±5.95)个,且语音训练前后舌尖音错误个数的差异有统计学意义(t=?11.330,P0.001和t=?17.130,P0.001)。结论腭裂术后腭咽闭合完全的患者舌尖音异常的临床特点以置换和脱落为主;轻度腭咽闭合不全的患者舌尖音异常的临床发音特点以鼻音构音、浊化代偿和脱落为主;两类患者舌尖音异常的语音特点有很大差别。根据患者发音特点的不同,为其制定特异性的语音训练方案,可以提高临床中语音训练的效果。本研究中制定的语音训练方法有效。
[Abstract]:Although the cleft palate patients have established normal palatopharynx closed anatomical structure after operation, but if they do not have speech training, the movement of soft palate is still very poor, and there are still bad pronunciation habits, so that normal speech can not be obtained. It makes the communication and communication between patients and people produce obstacles, which has a negative impact on their study, life and work, and makes the patients have a serious inferiority complex, which makes them unable to integrate into the normal social life. This study analyzed the clinical and acoustic characteristics of tongue tip sound in patients with abnormal tongue tip sound after cleft palate operation, in order to provide the basis for the establishment of individualized and effective phonetic training program. To provide a reference for the clinical development of postoperative cleft palate patients voice training. Objective to analyze the phonological characteristics of patients with complete and mild velopharyngeal incompetence after cleft palate surgery, and to explore the methods of speech training for two types of patients. Methods from July 2012 to December 2014, 220 patients (117 males and 103 females) with abnormal tongue tip sound after cleft palate surgery were collected from the Department of phonology Therapy, first affiliated Hospital of Zhengzhou University. The ratio of male to female was 1.1: 1. The age was 4 to 25 years old. The average age was (10.89 卤8.65) years. According to the speech articulation test table of West China Stomatology Hospital, 220 patients with abnormal articulation of tongue tip were detected by CSL, and the clinical characteristics of dysarthria were analyzed. According to the Chinese phonetic articulation test table, 42 patients who met the inclusion criteria were recorded before and after training respectively, and the number of tongue tip sound errors before and after training were calculated. SPSS 17.0 statistical software was used for statistical processing. The experimental design type of this study is self-paired design. The effect of phonetic training of tongue tip is tested by paired t test, and the level of 伪 -0. 05 is tested. Results there were 108 cases of complete palatopharynx closure after cleft palate, 112 cases of patients with palatopharynx insufficiency and 108 cases of complete palatopharynx closure. The percentages were 82.48.1and 11.112 patients with mild velopharyngeal incompetence. The main features of abnormal tongue sound were the rhinorrhaphy of / and rout / rr / r / h / r / c / s / turbidity / turbid compensation / loss of / loss / the turbidization of the / or / or the turbidity of the / 59.8% (67 cases), 50.0% (56 cases), 40.2% (45 cases), 25% (28 cases), 19.6% (22 cases), respectively. After speech training, the number of tongue tip errors decreased (22.19 卤8.98) and (22.24 卤5.95) respectively in patients with complete palatopharynx closure and mild palatopharynx incompetence after cleft palate surgery, and there were significant differences in the number of tongue tip sound errors between before and after speech training (t / C 11.330 P0.001 and t17.130 / P0.001). Conclusion the clinical features of abnormal tongue tip sound in patients with complete palatopharynx closure after cleft palate are mainly replacement and abscission, and the clinical characteristics of abnormal tongue tip sound in patients with mild palatopharynx incompetence are nasal tone, turbid compensation and abscission. The phonological characteristics of the abnormal tip of the tongue in the two groups of patients are very different. According to the different phonetic characteristics of the patients, a specific phonetic training scheme can improve the effect of phonetic training in clinic. The phonetic training method developed in this study is effective.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R782.22

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