腭裂儿童鼻音功能亢进声学参数鉴别方程模型的建立及临床验证

发布时间：2018-08-31 13:36

【摘要】：腭裂患者由于鼻音功能亢进从而影响言语清晰度和沟通流畅。对鼻音功能亢进的腭裂儿童来讲,有效准确地评估鼻音功能亢进,关系到腭裂患者能否及时得到有效地言语训练。鼻音功能亢进的评估分为主观评估和客观评估,其中主观评估对评估者的要求很高,而客观评估常以单一参数的评估为主,存在一定的局限性,因此简单有效的多参数模型评估越来越受到国内外学者的关注。本研究从声学方面的客观参数出发,通过三个系列研究,建立和验证了评估腭裂鼻音功能亢进的鉴别方程模型。研究一腭裂鼻音功能亢进敏感声学参数的提取。(一)通过文献初步筛选出与鼻音功能亢进有关的声学参数,包括呼吸、发声、共鸣三个方面的参数。(二)通过比较3-14岁的30名腭裂鼻音功能亢进的儿童与30名普通儿童的上述声学参数,得到了10个有显著差异的参数。(三)通过客观参数敏感性的实验,从10个有差异的参数中,最终提取了4个敏感性的声学参数,分别为最长声时、i的0.5k-1k能量集中率、i的3k-4k能量集中率和鼻流量。最后通过客观参数相关性的实验,得到i的0.5k-1k能量集中率和i的3k-4k能量集中率呈高度相关。最终保留了3个敏感性的声学参数,分别为最长声时、i的3k-4kHz能量集中率和鼻流量。研究二腭裂鼻音功能亢进鉴别方程模型的建立与验证。模型建立采用的是鉴别分析的方法。通过65个被试建立了鉴别方程模型,模型为:Y0=-17.531+0.833XMPT+0.569Xi(3k-4k)+0.514XMNSY1=-19.880+0.006XMPT+0.595Xi(3k-4k)+0.768XMNSY2=-23.824+0.473XMPT+0.354Xi(3k-4k)+0.906XMNSY3=-21.854-0.216XMPT+0.409Xi(3k-4k)+0.923XMNS模型总体鉴别的准确性为73.8%。通过10个被试对模型进行验证,得到鉴别方程模型的判别与主观评估的一致性为70%。研究三腭裂鼻音功能亢进鉴别方程模型的临床应用。实验选用一名4岁Ⅱ度腭裂儿童,运用鉴别方程模型分别对术前和术后进行鼻音功能亢进的评估,发现其与主观评估结果的一致率为100%。进一步证明此模型的有效性。
[Abstract]:Cleft palate patients suffer from nasal hyperactivity, which affects speech clarity and communication fluency. For cleft palate children with nasal hyperfunction, effective and accurate evaluation of nasal hyperactivity is related to whether cleft palate patients can get effective speech training in time. The assessment of nasal hyperactivity can be divided into subjective assessment and objective assessment. Therefore, simple and effective multi-parameter model evaluation has attracted more and more attention from scholars at home and abroad. Based on the objective parameters of acoustics and three series of studies, a differential equation model for the evaluation of cleft palate nasal hyperactivity was established and verified. To study the extraction of sensitive acoustic parameters of a cleft palate with hyperfunction of nasal sound. (1) the acoustic parameters related to nasal hyperactivity, including breathing, phonation and resonance, were preliminarily screened by literature. (2) by comparing the above acoustic parameters between 30 children with cleft palate and 30 normal children aged 3-14 years, 10 parameters with significant difference were obtained. (3) through the experiment of sensitivity of objective parameters, four sensitive acoustic parameters were extracted from 10 different parameters, which were 3k-4k energy concentration rate and nose flow rate of 0.5k-1k energy concentration rate of the longest sound time. Finally, through the experiment of the correlation of objective parameters, it is found that I's 0.5k-1k energy concentration rate is highly correlated with I's 3k-4k energy concentration rate. Finally, three sensitive acoustic parameters were retained, which were the 3k-4kHz energy concentration rate and nose flow rate of the longest acoustic time. To study the establishment and verification of the differential equation model for nasal hyperactivity of second palate cleft palate. The method of discriminant analysis is used to establish the model. The discriminant equation model was established by 65 subjects, and the overall accuracy of the model was 73.8%. The model was -17.531 0.833XMPT 0.569Xi (3k-4k) 0.514XMNSY1=-19.880 0.006XMPT 0.595Xi (3k-4k) 0.768XMNSY2=-23.824 0.473XMPT 0.354Xi (3k-4k) 0.906XMNSY3=-21.854-0.216XMPT 0.409Xi (3k-4k) 0.923XMNS. The consistency between discriminant equation model and subjective evaluation is 70. To study the clinical application of the differential equation model of nasal hypertonia in patients with cleft palate. A 4-year-old second degree cleft palate child was used to evaluate nasal hyperfunction before and after operation by using differential equation model. The validity of the model is further proved.
【学位授予单位】：华东师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R782.22

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