嗓音训练前后对女性肌紧张性发声障碍患者发声空气动力学结果分析

发布时间：2019-04-03 18:31

【摘要】：目的分析嗓音训练治疗女性肌紧张性发声障碍(muscular tension dysphonia,MTD)前后患者发声空气动力学的变化,探讨空气动力学检测对噪音训练治疗MTD疗效评估的意义。方法对19例诊断为MTD的女性患者(病例组)进行12周嗓音训练,训练内容包括凸腹凹腹气息练习、凸腹控制膈肌练习、快速呼吸练习、放松舌根和喉部肌肉练习及诵读发声练习,于训练前、训练12周后采用言语发声空气动力学测试系统分别检测病例组的肺活量、舒适发声时的声门下压、空气动力能、平均气流率、声门阻力及最长声时,并与19例正常成年女性(对照组)进行对比分析。结果病例组训练前的中位声门下压(10.80cmH2O)、声门阻力[108.01cm H2O/(Lit/Sec)]及空气动力能(0.15watts)较正常对照组升高,中位肺活量(2.7L)及最长声时(12.51s)缩短,差异有统计学意义(P0.05);训练12周后患者组中位声门下压(7.87cmH2O)、声门阻力[67.25cm H2O/(Lit/Sec)]及空气动力能(0.08watts)较训练前下降,中位肺活量(3.0L)及最长声时(20.85s)较训练前增加,差异有统计学意义(P0.05);训练12周后病例组上述各指标与正常对照组相比差异均无统计学意义(P0.05)。结论嗓音训练可降低MTD患者发声时的声门下压、声门阻力及空气动力能,增大肺活量,延长最长声时;通过发声空气动力学检测能定量评估嗓音训练治疗女性MTD的效果。
[Abstract]:Aim to analyze the changes of vocal aerodynamics before and after voice training in female patients with myotonic dysarthria (muscular tension dysphonia,MTD), and to explore the significance of aerodynamics in evaluating the efficacy of noise training in the treatment of MTD. Methods 19 female patients diagnosed as MTD (case group) were trained for 12 weeks. The training contents included abdominal and concave breath training, abdominal control diaphragmatic exercise and rapid breathing exercise. Before and after 12 weeks of training, the vital capacity, subglottic pressure and aerodynamic energy of the patients were measured by the verbal voiceover aerodynamics test system, which was used to relax the muscles of the tongue and throat, and to recite and pronounce the vocal activity before training and 12 weeks after the training, the vital capacity, the subglottic pressure and the aerodynamic energy were measured respectively. The mean air flow rate, glottic resistance and maximum sound were compared with those of 19 normal adult females (control group). Results before training, the median subglottic pressure (10.80cmH2O), glottic resistance [108.01cm H2O/ (Lit/Sec)] and aerodynamic energy (0.15watts) in the patient group were higher than those in the normal control group. The median vital capacity (2.7L) and the longest sound time (12.51s) were shortened (P0.05). After 12 weeks of training, the median subglottic pressure (7.87cmH2O), glottic resistance [67.25cm H2O/ (Lit/Sec)] and aerodynamic energy (0.08watts) were lower than those before training. The median vital capacity (3.0L) and the longest sound time (20.85s) were significantly higher than those before training (P0.05). After 12 weeks of training, there was no significant difference in the above indexes between the case group and the normal control group (P0.05). Conclusion Voice training can reduce subglottic pressure, glottic resistance and aerodynamic energy in MTD patients, increase vital capacity and prolong maximum vocal time, and quantitatively evaluate the efficacy of voice training in treatment of female MTD by vocal aerodynamics test. [WT5 "HZ] conclusion\?
【作者单位】：中山大学孙逸仙纪念医院耳鼻咽喉科;河南中医学院第一附属医院耳鼻咽喉科;顺德区第一人民医院耳鼻咽喉科;
【基金】：广东省科技计划基金资助(2010B060900050;2011B010200024)
【分类号】：R764

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