悬雍垂腭咽成形术对OSAHS患者嗓音的影响

发布时间：2018-03-25 23:53

本文选题：悬雍垂腭咽成形术　切入点：嗓音　出处：《天津医科大学》2012年硕士论文

【摘要】：目的：悬雍垂腭咽成形术(uvulopalatopharyngoplasty, UPPP)对阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea Hypopnea Syndrome, OSAHS)患者手术前后的嗓音影响研究。通过多维嗓音分析软件(Multi-Dimensional Voice Program, MDVP)、线性预测谱(Linear Prediction Coding, LPC)、鼻流计(Nasometer)检测等方法,对OSAHS成年男性患者行UPPP手术前后的嗓音进行客观评价和分析,探讨手术前后咽腔的改变对患者发声功能和口鼻共鸣功能的影响,从而为选择UPPP手术人群提供参考、建立更合理OSAHS的管理和治疗手段提供依据。方法：对30例确诊为OSAHS的成年男性患者行UPPP,并分别在术前、术后一周及术后三月时通过多维嗓音分析软件、线性预测谱、鼻流计检测等方法,对元音/a/的基频(Average Fundamental Frequency, FO),频率微扰(Jitter)、振幅微扰(Shimmer),谐噪比(Noise-to-Harmonic Ratio, NHR)进行测量以客观评价其发声功能；对元音/a/i/u/的第一共振峰(Formant1, F1)、第二共振峰(Formant2,F2)进行测量以客观评价其口腔共鸣功能；对非鼻音句、口鼻音句、鼻音句的鼻音率进行测量以客观评价其鼻腔共鸣功能,继而对患者手术前后各参数结果进行统计学分析比较。结果： 1.多维嗓音分析软件显示,手术前后F0、Jitter、Shimmer、NHR均无显著性差异(P0.05)。 2.线性预测谱分析显示,术后一周时元音/a/、/i/、/u/的F1、F2较术前无显著性差异(P0.05)；术后三月时元音/i/的F1、F2及元音/u/的F1较术前差异仍无统计学意义(P0.05),但元音/a/的F1、F2及元音/u/的F2较术前升高(P0.05)。 3.鼻流计分析显示,术后一周时非鼻音句、口鼻音句、鼻音句的鼻音率较术前无明显差异(P0.05)；术后三月时非鼻音句、口鼻音句的鼻音率较术前仍无明显差异(P0.05),但鼻音句的鼻音率较术前则略有升高(P0.05)。提示手术对患者的发声功能无明显影响,对声道共鸣功能有一定影响。结论： 1. UPPP对OSAHS患者嗓音影响较小,对其发声功能无明显影响,但对口鼻共鸣功能产生轻微影响。 2.鉴于UPPP对口鼻共鸣功能产生轻微影响,对专业歌唱、戏曲及播音主持等职业用声者行UPPP时还需要慎重,并且一定要对其告知手术对嗓音改变的可能性。
[Abstract]:Objective:. The effect of uvulopalatopharyngoplasty on voice of patients with obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) before and after operation. Nasometerometer, etc., Objective evaluation and analysis of voice of adult male patients with OSAHS before and after UPPP operation were carried out to explore the influence of changes of pharynx cavity on vocal function and oral and nasal resonance function of patients before and after UPPP operation. To establish more reasonable management and treatment of OSAHS to provide the basis. Methods:. Thirty adult male patients with OSAHS were treated with UPP, and were analyzed by multi-dimensional voice analysis software, linear predictive spectrum and nasal flow meter before operation, one week after operation and three months after operation. The fundamental frequency of vowel / / is measured by measuring the fundamental frequency of vowel / Fundamental frequency frequency, frequency perturbation, amplitude perturbation, amplitude perturbation and harmonic noise ratio Noise-to-Harmonic Ratio (NHRs) in order to objectively evaluate the vocal function of the vowel / a / a / /, the first resonance peak of vowel / a / r / F _ (1), F _ (1), F _ (2) is measured to evaluate objectively its oral resonance function; the first resonance peak of the vowel / / / is Formant _ 1, F _ (1), and the second resonance peak (F _ (2)) is measured to evaluate its oral resonance function objectively. The nasal rate of non-nasal, oral and nasal sentences was measured in order to evaluate the nasal resonance function objectively, and then the results of the parameters before and after operation were statistically analyzed and compared. Results:. 1.Multidimensional voice analysis software showed that there was no significant difference in NHR between F0 and Jitteror Shimmerin before and after operation (P 0.05). 2. Linear predictive spectrum analysis shows that, At one week after operation, there was no significant difference in the vowel / a / r / u / F 1 / F 2 compared with that before operation (P 0.05); the vowel / I / F 1 and vowel / F 1 at 3 months after operation were still not significantly different from those before operation (P 0.05), but the vowel / a / F 1 F 1 / F 2 and the vowel r / u / F 2 were significantly higher than those before operation (P 0.05). 3. Nasal flow analysis showed that there was no significant difference in the nasal rate of non-nasal, oral, nasal and nasal sentences one week after operation compared with that before operation (P 0.05), and at 3 months after operation, there was no significant difference in the rate of nasal sounds in non-nasal sentences, and in the third month after operation, there was no significant difference between the two groups. There was no significant difference in nasal sound rate between before and after operation, but the nasal sound rate of nasal sentence was slightly higher than that before operation (P 0.05). It suggested that the operation had no obvious effect on the vocal function of patients, but had certain influence on the vocal resonance function of the patients. Conclusion:. 1. UPPP had little effect on the voice of OSAHS patients, but had little effect on the vocal function of OSAHS patients, but had a slight effect on the resonance function of mouth and nose. 2. In view of the slight influence of UPPP on the oral and nasal resonance function, it is necessary to be cautious in performing UPPP for professional speakers such as singing, opera and broadcasting hosts, and to inform them of the possibility of voice change.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R766

【参考文献】