声带息肉及小结声门闭合面积与声学及空气动力学指标的相关性研究

发布时间：2018-08-27 15:46

【摘要】：目的 探讨声带息肉及声带小结患者发音时最小声门面积(Minimum Glottal Area, MGA)与声学指标(基频微扰、振幅微扰、谐噪比)及空气动力学指标(平均气流率、声门阻力、声门下压力)的相关性。 方法 对50例正常人(女30例,男20例),35例声带息肉患者及36例声带小结患者进行检查,以频闪喉镜从口腔插入,检查声带,嘱患者发“[i：]”音,并记录检查视频,应用配套KIPS软件计算声门发音时最小声门面积(正常组仅查此项)；采用CSL3700(Computerized Speech Lab3700),评估基频微扰(Jitter)、振幅微扰(Shimmer)、谐噪比(harmony to noise ratio, HNR);以空气动力学嗓音功能分析仪(Aerophone Ⅱ Voice Function Analyzer)及配套软件测得平均气流率(mean airflow rate, MFR)、声门阻力(glottal resistance, Rg)、声门下压力(subglottal pressure, SGP),以发音时最小声门面积与这些指标进行比较、分析。用30例正常女性发音时最小声门面积与声带小结组进行配对资料t检验,检验标准为a=0.05；用全部50例正常人的发音时最小声门面积与声带息肉患者进行配对资料t检验,检验标准为a=0.05。采用pearson相关分析检验发音时最小声门面积与患者发音时空气动力学指标及声学指标之间的相关性,P0.05有统计学意义。 结果 正常女性发音时最小声门面积与声带小结比较差别有统计学意义(P0.05)；所有正常人发音时最小声门面积与声带息肉患者比较差别有统计学意义(P0.05)。患者组以发音时最小声门面积与其他指标进行一一比较,仅声带小结患者的发音时最小声门面积与声门下压力无明显相关性(r=0.060,P0.05)；声带息肉组发音时最小声门面积与基频微扰(r=0.968,P0.05)振幅微扰(r=0.981,P0.05)及平均气流率(r=0.995,P0.05)呈正相关关系,与声门阻力(r=-0.998,P0.05)及谐噪比(r=-0.996,P0.05)呈负相关关系,发音时最小声门面积与其他指标关系在声带小结组与息肉组相同(r=0.990,P0.05；r=0.996,P0.05；r=0.996,P0.05；r=-0.992,P0.05；r=-0.992,P0.05),声带息肉组发音时最小声门面积与声门下压力呈正相关关系(r=0.997,P0.05)。 结论 声带息肉及声带小结患者发音时最小声门面积较正常人增大,声门闭合不良造成基频微扰、振幅微扰、平均气流率及噪音成分增加,是造成声音嘶哑的一个重要原因。发音时最小声门面积与基频微扰、振幅微扰、谐噪比、声门下压力(声带小结除外)、平均气流率及声门阻力有明显的相关性,发音时最小声门面积也可以作为评判声带息肉及声带小结病变严重程度的一项指标。用频闪喉镜并配合kips软件进行发音时最小声门面积测量是简单易行的办法。
[Abstract]:Objective to investigate the minimum glottic area (Minimum Glottal Area, MGA) and acoustic indices (fundamental frequency perturbation, amplitude perturbation, harmonic noise ratio) and aerodynamics (mean airflow rate, glottic resistance) in patients with vocal cord polyps and vocal nodules. Subglottic pressure). Methods 35 patients with vocal cord polyps and 36 patients with vocal cord nodules were examined in 50 normal subjects (30 women and 20 men). The vocal cords were inserted from the mouth by stroboscopic laryngoscope, and the patients were asked to make the "[I:]" sound. The video was recorded and the minimum glottic area was calculated by using the matching KIPS software. Evaluation of fundamental Frequency perturbation (Jitter), amplitude perturbation (Shimmer), Harmonic noise ratio (harmony to noise ratio, HNR);) by using CSL3700 (Computerized Speech Lab3700, the average airflow rate of (mean airflow rate, MFR), glottic resistance (glottal resistance, Rg), was measured by Aerophone 鈪，

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