DSI的正常值测定及评估声带息肉患者嗓音的应用研究

发布时间：2018-04-14 23:06

本文选题：嗓音障碍严重指数（DSI） + 嗓音障碍　；参考：《暨南大学》2012年硕士论文

【摘要】：嗓音医学作为一个新兴学科在我国刚起步，在嗓音障碍评估方面目前有许多方法，但总体可分为主观评估和客观评估。DSI（Dysphonia Severity Index）作为评估嗓音障碍程度的多参数方法在欧洲普遍使用，但在我国目前还鲜少有报道。本研究将分为二个部分来讨论DSI在我国的应用前景及对声带息肉患者嗓音障碍程度的评估。第一部分目的DSI（Dysphonia Severity Index）在欧洲已有较多研究，但欧洲的DSI值范围是否能适用于人种与语言环境都不同的亚洲还没有人涉足，，本研究的目的就是探讨DSI值在中国人群中正常值范围。方法招募嗓音正常，无嗓音疾病及治疗史的不吸烟的志愿者（35例）分别进行VHI评估，MPT，jitter，F0-high，I-low及DSI的测量。运用统计学方法，计算出DSI值的90%参考值范围作为正常值的范围。并使用方差分析以上各指标在性别之间的差异。结果除1人VHI值超过18被筛选出实验，剩下正常人群的DSI值范围是（-1.24~5.84），均数为2.3±2.16，比欧洲研究中的DSI值（均数）要低。除了F0-high值以外，其他值均未体现出男女性别之间的差异。结论采用Divas系统测试的DSI值在中国南方地区人群中的测试结果不同于欧洲人群。DSI是一个中性的指标，与性别无关。第二部分目的使用嗓音障碍严重指数（DSI）对患有声带息肉疾病患者治疗效果进行评估，讨论DSI评估嗓音障碍程度的有效性和可靠性。方法本研究选取正常人（34例）与患有声带息肉的病人（33例），通过手术干预，设立空白对照组，术前组与术后组。分别进行VHI评估，GRBAS评分，纤维电子喉镜检查，测量MPT、jitter、shimmer及DSI值。运用统计学方法，通过one-way ANOVA方差分析DSI值在三组间的差异。并用VHI，GRBAS评分，MPT，jitter，shimmer与DSI做相关性研究。结果DSI值在空白组中的均值为2.3±2.16，术前组中的均值-3.92±4.97，术后组的均值是1.3±1.68，根据one-way ANOVA方差分析，空白组与术前组（p值），术前与术后组之间的均值有差异（p0.05）。但是空白组与术后组之间的差异无统计学意义。通过pearson相关分析，得到DSI值与VHI值，G值，R值，MPT，jitter，shimmer之间的相关性强(p0.01)。结论DSI在评估声带息肉患者的病理嗓音障碍程度上是有效和准确的。可作为一个独立使用的评估嗓音障碍程度的多参数方法，还可作为对声带息肉的手术疗效进行客观评价。
[Abstract]:As a new subject, voice medicine has just started in China, and there are many methods in the evaluation of voice disorders.However, the method can be divided into subjective assessment and objective evaluation. Dy sphonia Severity Index is widely used in Europe as a multi-parameter method to assess the degree of voice disorders. However, there are few reports in China at present.This study will be divided into two parts to discuss the application of DSI in China and to assess the degree of voice disorders in patients with vocal cord polyps.Part oneObjective DSI(Dysphonia Severity Index has been widely studied in Europe, but whether the range of DSI values in Europe can be applied to Asia with different ethnic and linguistic environments has not been explored. The purpose of this study is to explore the normal range of DSI values in Chinese population.Methods 35 non-smoking volunteers with normal voice and no history of voice disease were recruited. The VHI was used to evaluate the I-low and DSI of MPTjitterus F0-high.The range of 90% reference value of DSI value is calculated as the range of normal value by statistical method.ANOVA was used to analyze the gender differences between the above indicators.Results except for one person whose VHI value was more than 18, the range of DSI value in the rest of the population was -1.2455.84, the mean value was 2.3 卤2.16, which was lower than the DSI value (mean) in the European study.With the exception of the F0-high value, none of the other values reflected the gender difference between men and women.Conclusion the DSI values measured by Divas system in the population of southern China are different from those of European population. DSI is a neutral index and has nothing to do with gender.Part twoObjective to evaluate the efficacy of DSI in the treatment of patients with vocal cord polyposis by using the severity index of voice disorders (DSI) and to discuss the validity and reliability of DSI in assessing the degree of voice disorders.Methods Thirty-four normal persons and 33 patients with vocal cord polyps were selected in this study. The blank control group was established by operation intervention, preoperative group and postoperative group.VHI was used to evaluate GRBAS, fiberoptic laryngoscope was performed, and MPT jittershimmer and DSI were measured.The difference of DSI value among the three groups was analyzed by one-way ANOVA variance analysis with statistical method.The correlation between DSI and VHI GRBAS score was studied.Results the mean value of DSI was 2.3 卤2.16 in the blank group, -3.92 卤4.97 in the preoperative group and 1.3 卤1.68 in the postoperative group. According to the analysis of variance of one-way ANOVA, there was significant difference in the mean value of DSI between the blank group and the preoperative group (P 0.05).But there was no significant difference between the blank group and the postoperative group.By pearson correlation analysis, the correlation between DSI value and VHI value G value and R value was obtained, and the correlation between DSI value and VHI value was strong (p 0.01).Conclusion DSI is effective and accurate in assessing the degree of pathological voice disorders in patients with vocal cord polyps.It can be used as an independent multi-parameter method to evaluate the degree of voice disorders, and can also be used as an objective evaluation of the surgical effect of vocal cord polyps.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R767.4

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