前发声期嗓音参数参考标准的制定及临床应用研究

发布时间：2018-05-13 07:19

本文选题：嗓音测量 + 前发声期　；参考：《华东师范大学》2010年博士论文

【摘要】： 客观全面的嗓音评估是嗓音治疗的基础。随着计算机技术的发展和嗓音医学的进步,针对嗓音功能的主观和客观测量手段日渐丰富,尤其是嗓音的客观测量技术,在嗓音疾病的诊断和治疗中发挥着重要作用。本论文在国内外嗓音客观测量研究的基础上,首次采用能对瞬态和稳态声波进行提取分析的“发声测量仪”(Phonation)为测量工具,选择F0、Jitter、OQ. SQ、STF和AQ作为研究参数,对前发声期嗓音参数进行了系列研究。研究内容主要包括：前发声期与稳定期嗓音参数的比较,前发声期嗓音测试语料的选择,成人正常与病理嗓音的比较及学前儿童正常与病理嗓音的比较分析,正常成人与学前儿童前发声期嗓音参数的特征分析,前发声期嗓音参数参考标准的制订以及前发声期嗓音参数及其参考标准在临床中的应用。通过本论文的实验研究,取得了以下阶段性研究成果：1.前发声期与稳定期的嗓音参数存在显著性差异：前发声期与稳定期之间的Jitter、OQ和SQ具有极显著差异(p0.01), F0、STF和AQ具有显著性差异(p0.05)。2.选择出了前发声期嗓音测试的最佳语料：成人为／ba／,儿童为／gu／。3.通过正常与病理嗓音的对比研究,发现成人及儿童正常和病理嗓音参数在前发声期及稳定期具有不同的特点：成人及儿童正常和病理嗓音前发声期参数F0、Jitter、OQ具有显著差异(p0.05):OQ和FO正常值高于异常值,而Jitter正常值低于异常值。成人Jitter、SQ、AQ和STF四个参数在不同嗓音和发声阶段之间存在交互作用(p0.05),儿童F0、Jitter和AQ三个参数在不同嗓音和发声阶段之间存在交互作用(p0.05),其前发声期的变化比稳定期的变化表现更为明显。学前儿童性别和年龄段之间各个前发声期参数均无明显差异(p0.05)。4.制订了成人及学前儿童前发声期嗓音参数的参考标准；5.发现不同类型的嗓音障碍其前发声期嗓音参数具有不同的特点：功能性和器质性嗓音障碍的FO值低于神经性嗓音障碍；功能性嗓音障碍的Jitter、STF值低于器质性和神经性嗓音障碍；功能性嗓音障碍在AQ上却高于器质性和神经性嗓音障碍,为嗓音障碍的鉴别诊断提供了新的思路和一定的参考价值。6.通过前发声期嗓音参数及其参考标准的临床应用,验证了嗓音治疗的有效性,并初步证实了前发声期嗓音参数参考标准在临床嗓音治疗及疗效监控中的重要作用。通过本论文的研究,证明前发声期的嗓音参数及参考标准对于嗓音诊断和疗效监控具有重要意义,为嗓音功能的客观测量提供了新的途径和手段。在后继的研究中,将拓宽研究对象的年龄和病理嗓音的类型,增加样本量,进一步研究前发声期嗓音参数的生理和病理特点,完善前发声期嗓音参数参考标准的制订,以更好地应用于嗓音临床和研究工作。
[Abstract]:Objective and comprehensive voice evaluation is the basis of voice therapy. With the development of computer technology and the progress of voice medicine, subjective and objective measurement methods for voice function are becoming more and more abundant, especially the objective voice measurement technology, which plays an important role in the diagnosis and treatment of voice diseases. Based on the objective measurement of voice at home and abroad, the phonometer (phonometer), which can extract and analyze transient and steady acoustic waves, is used as the measuring tool for the first time in this paper, F0 Jittero OQ is chosen as the measuring tool. SQSTF and AQ were used as parameters to study the voice parameters of prevocal period. The main contents of the study include: the comparison of voice parameters between pre-vocal period and stable period, the choice of voice test corpus, the comparison between normal voice and pathological voice in adults, and the comparison between normal voice and pathological voice in preschool children. The characteristic analysis of voice parameters in normal adults and pre-school children, the establishment of reference standards for voice parameters in pre-phonation period, and the application of voice parameters and reference standards in clinical practice. Through the experimental research in this paper, the following stage research results are obtained: 1. There were significant differences in voice parameters between prevocal period and stable stage: there was a significant difference between pre-vocal stage and stable stage in Jittero OQ and sq, and between F0 and AQ. There was significant difference between F0 and AQ. The best data for the pre-vocal voice test were selected: adults were / ba / r and children were / gur / r. 3. Through a comparative study of normal and pathological voices, It was found that the normal and pathological voice parameters of adults and children had different characteristics during the prevocal period and the stable period. The normal values of normal and pathological voice parameters F0 and Jittero OQ were significantly different between adults and children, and the normal values of P0.05: OQ and FO were higher than the abnormal values. The normal value of Jitter is lower than the outlier. There was interaction between the four parameters of AQ and STF in adults in different voice and vocal stage. In children, there was interaction between the three parameters of F0, Jitter and AQ in different voice and vocal stage. The change of prephonation period was higher than that of stable stage. Change performance is more obvious. There was no significant difference in the parameters of prephonation period between the sex and age groups of preschool children (p 0.05. 4). The reference standard for voice parameters of prephonation period in adults and preschool children was established. It was found that different types of voice disorders had different characteristics in the pre-phonation stage: the FO value of functional and organic voice disorders was lower than that of neurogenic voice disorders, the STF value of Jitterus of functional voice disorders was lower than that of organic and neurogenic voice disorders, and the FO values of functional and organic voice disorders were lower than those of neurogenic voice disorders. Functional voice disorders are higher in AQ than in organic and neurotic voice disorders, which provides a new idea and a certain reference value for the differential diagnosis of voice disorders. The effectiveness of voice therapy was verified by the clinical application of voice parameters and their reference standards in the prephonation period. The important role of the reference standards in the clinical voice therapy and the monitoring of curative effect was preliminarily confirmed. Through the research in this paper, it is proved that the voice parameters and reference standards in the pre-vocal period are of great significance for the diagnosis and monitoring of the curative effect of the voice, and provide a new way and means for the objective measurement of the voice function. In the subsequent studies, we will broaden the age of the subjects and the types of pathological voices, increase the sample size, further study the physiological and pathological characteristics of the voice parameters in the pre-vocal period, and improve the formulation of the reference standards for the parameters of the voice in the pre-vocal period. To better apply to voice clinical and research work.
【学位授予单位】：华东师范大学
【学位级别】：博士
【学位授予年份】：2010
【分类号】：R767.92

【引证文献】