发声空气动力学检测对声带息肉患者术后疗效评估的意义
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摘要
目的探讨发声空气动力学检测用于声带息肉患者术后疗效评估的意义。方法 78例声带息肉患者手术前后及80例正常成人行发声空气动力学检测,比较两组平均气流率、最长发声时间、声门下压、声门效率和声门阻力。结果声带息肉患者术前的平均气流率、最长发声时间、发声效率、声门阻力的中位数[25分位数;75分位数]分别为0.25[0.20;0.35]L/s、9.2[6.9;12.5]s、64.2[28.5;155.9]×10~(-6)、68.2[37.6;129.7]cmH_2O/(l/s),声门下压平均为9.0±2.1cmH_2O;术后分别为0.13[0.08;0.21]L/s、15.9[0.8;20.7]s、79.8[32.7;195.8]×10~(-6)、45.6[33.2;126.7]cmH_2O/(L/s)(5.6±1.7cmH_2O);正常对照组分别为0.14[0.11;0.20]L/s、17.3[13.8;23.2]s、82.5[35.1;210.4]×10~(-6)、43.7[32.8;43.1]cmH_2O/(l/s)、5.4±1.3cmH_2O。可见,声带息肉患者术前的平均气流率和声门下压均明显高于术后和正常对照组(P<0.05),而术后与正常对照组比较差异无统计学意义(P>0.05);声带息肉患者术前的最长发声时间和发声效率明显低于术后和正常对照组(P<0.05),而术后与正常对照组比较差异无统计学意义(P>0.05);声带息肉患者手术前后与正常对照组之间声门阻力比较差异无统计学意义(P>0.05)。结论声带息肉患者手术后发声空气动力学检测的平均气流率、声门下压、最长发声时间和发声效率较术前明显改善,可作为患者术后疗效客观、量化评估的方法之一。
Objective To study the application of aerodynamic test on the postoperative evaluation in patients with vocal polyps.Methods A total of 78 cases of vocal polyp patients undergoing surgical treatment and 80 normal adult were included,and were divided into vocal polyp preoperative group,vocal polyp postoperative group and normal control group.The three groups all received aerodynamics test.The mean flow rate、maximum phonation time、subglottal pressure、vocal efficiency and glottal resistance were analyzed and compared.Results The mean flow rate,maximum phonation time,vocal efficiency,glottal resistance subglottal pressure of vocal polyp preoperative group were 0.25[0.20;0.35],9.2[6.9;12.5],64.2[28.5;155.9],68.2[37.6;129.7],9.0±2.1 cmH_2O/(L/s);whereas the vocal polyp postoperative group and normal control group were 0.13[0.08;0.21],15.9[0.8;20.7],79.8[32.7;195.8],45.6[33.2;126.7],5.6±1.7 cmH_2O/(L/s)and 0.14[0.11;0.20],17.3[13.8;23.2],82.5[35.1;210.4],43.7[32.8;43.1],5.4±1.3 cmH_2O/(L/s).The mean flow rate and subglottal pressure in vocal polyp preoperative group were significantly higer than vocal polyp postoperative group and normal control group(P<0.05).However,there were no significant difference between vocal polyp postoperative group and normal control group(P>0.05).The maximum phonation time and vocal efficiency were signifcantly lower than vocal polyp postoperative group and normal control group(P<0.05).However,there were no significant difference between vocal polyp postoperative group and normal control group(P>0.05).There was no statistical difference among the three groups of glottal resistance.Conclusion The mean flow rate、subglottal pressure、maximum phonation time and vocal efficiency were significantly different before and after vocal polyp operation.An objective and quantitative assessment of the postoperative efficacy of vocal polyps can be evaluated by aerodynamics.
Objective To study the application of aerodynamic test on the postoperative evaluation in patients with vocal polyps.Methods A total of 78 cases of vocal polyp patients undergoing surgical treatment and 80 normal adult were included,and were divided into vocal polyp preoperative group,vocal polyp postoperative group and normal control group.The three groups all received aerodynamics test.The mean flow rate、maximum phonation time、subglottal pressure、vocal efficiency and glottal resistance were analyzed and compared.Results The mean flow rate,maximum phonation time,vocal efficiency,glottal resistance subglottal pressure of vocal polyp preoperative group were 0.25[0.20;0.35],9.2[6.9;12.5],64.2[28.5;155.9],68.2[37.6;129.7],9.0±2.1 cmH_2O/(L/s);whereas the vocal polyp postoperative group and normal control group were 0.13[0.08;0.21],15.9[0.8;20.7],79.8[32.7;195.8],45.6[33.2;126.7],5.6±1.7 cmH_2O/(L/s)and 0.14[0.11;0.20],17.3[13.8;23.2],82.5[35.1;210.4],43.7[32.8;43.1],5.4±1.3 cmH_2O/(L/s).The mean flow rate and subglottal pressure in vocal polyp preoperative group were significantly higer than vocal polyp postoperative group and normal control group(P<0.05).However,there were no significant difference between vocal polyp postoperative group and normal control group(P>0.05).The maximum phonation time and vocal efficiency were signifcantly lower than vocal polyp postoperative group and normal control group(P<0.05).However,there were no significant difference between vocal polyp postoperative group and normal control group(P>0.05).There was no statistical difference among the three groups of glottal resistance.Conclusion The mean flow rate、subglottal pressure、maximum phonation time and vocal efficiency were significantly different before and after vocal polyp operation.An objective and quantitative assessment of the postoperative efficacy of vocal polyps can be evaluated by aerodynamics.
引文
1林生智,庄佩耘,郭永清,等.无创性空气动力学检查在嗓音医学中的研究进展[J].听力学及言语疾病杂志,2012,20:297.
2 余明强,潘晗,周莉,等.气流相关检查参数对嗓音功能评估的意义[J].中华耳鼻咽喉头颈外科杂志,2015,50:983.
3 杨宝琦,程俊萍.空气动力学在测试呼吸与发声关系中的临床应用[J].听力学及言语疾病杂志,2000,8:152.
4 Aghajanzadeh M,Darouie A,Dabirmoghaddam P,et al.The relationship between the aerodynamic parameters of voice and perceptual evaluation in the iranian population with or without voice disorders[J].Journal of Voice,2017,31:9.
5 郭永清,林生智,徐新林,等.空气动力学参数在嗓音功能评估中的意义[J].中华耳鼻咽喉头颈外科杂志,2012,47:858.
6 Jiang J,Stern J,Chen HJ.Vocal efficiency measurements in subjects with vocal polyps and nodules:apreliminary report[J].Ann Otol Rhinal Laryngol,2004,113:277.
2 余明强,潘晗,周莉,等.气流相关检查参数对嗓音功能评估的意义[J].中华耳鼻咽喉头颈外科杂志,2015,50:983.
3 杨宝琦,程俊萍.空气动力学在测试呼吸与发声关系中的临床应用[J].听力学及言语疾病杂志,2000,8:152.
4 Aghajanzadeh M,Darouie A,Dabirmoghaddam P,et al.The relationship between the aerodynamic parameters of voice and perceptual evaluation in the iranian population with or without voice disorders[J].Journal of Voice,2017,31:9.
5 郭永清,林生智,徐新林,等.空气动力学参数在嗓音功能评估中的意义[J].中华耳鼻咽喉头颈外科杂志,2012,47:858.
6 Jiang J,Stern J,Chen HJ.Vocal efficiency measurements in subjects with vocal polyps and nodules:apreliminary report[J].Ann Otol Rhinal Laryngol,2004,113:277.