山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (3): 59-64.doi: 10.6040/j.issn.1673-3770.0.2020.467
邢东升1,邸全红1,印有亮1,修世国2,张明龙3
XING Dongsheng1, DI Quanhong1, YIN Youliang1, XIU Shiguo2, ZHANG Minglong3
摘要: 目的 探索中文版嗓音疲劳指数量表(VFI)在职业用声者嗓音疲劳(VF)评估中的应用。 方法 观察组为因嗓音疲劳就诊的职业用声者120例,对患者进行电子喉镜内镜窄带成像技术(NBI)检查,填写中文版VFI量表调查问卷。观察组根据电子喉镜NBI下检查再次分组慢性喉炎组(A组)、声带小结组(B组)、声带肿物组(C组)。对照组为经电子喉镜NBI检查及自我表述无嗓音疾病的职业用声者20例。观察组A组、B组行雾化吸入治疗连续1周,声音休息,口服10 mL蓝芩口服液(3次/d),对症治疗1个月复查,行电子喉镜NBI检查及填写中文版VFI量表。观察组C声带肿物组行声带肿物切除术,标本行病理检查,根据病理结果再次分为良性肿物组(C1组)、恶性肿物组(C2组),术后雾化吸入连续1周,声音休息,口服10 mL蓝芩口服液(3次/d),对症治疗1个月复查。对数据资料进行统计分析。 结果 (1)观察组各组及对照组年龄比较,差异无统计学意义(均P>0.05),各组间性别构成比,差异无统计学意义(P=0.870 5>0.05);(2)观察组与对照组相比VFI评分Part1得分、Part2得分均高于对照组,Part3得分低于对照组,差异有统计学意义(P<0.001);(3)观察组A组与B组,C1组与C2组Part1/2/3得分比较,差异无统计学意义(P=0.125,P=0.492);A组、B组Part1得分均低于C1组,A组、B组Part2得分均低于C1组C2组,A组、B组Part3得分均高于C1组C2组,差异有统计学意义(P<0.05)。A组Part1得分低于C2组,差异有统计学意义(P=0.012)。B组Part1得分低于C2组,差异无统计学意义(P=0.056);(4)观察组A、B、C1各组经治疗后Part1、Part2VFI评分下降,Part3得分升高,差异有统计学意义(P<0.001)。观察组C2组经治疗后Part1、Part2VFI评分下降,Part3得分升高,差异无统计学意义(P=0.102)。 结论 中文版VFI量表能够对VF患者发音疲劳和发音回避、发音身体不适以及声音休息与症状的改善三因素提供准确的量化指标,可以用于职业用声者VF主观评估。
中图分类号:
[1] Nanjundeswaran C, Jacobson BH, Gartner-Schmidt J, et al. Vocal fatigue index(VFI): development and validation[J]. J Voice, 2015, 29(4): 433-440. doi:10.1016/j.jvoice.2014.09.012. [2] Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines[J]. J Clin Epidemiol, 1993, 46(12): 1417-1432. doi:10.1016/0895-4356(93)90142-n. [3] 倪晓光. 窄带成像喉镜临床应用[M]. 北京: 人民卫生出版社, 2019: 30-35. [4] 沈敏, 屈季宁, 姜义道. 客观嗓音分析比较CO2激光术与传统剥脱术治疗声带白斑患者的疗效[J]. 山东大学耳鼻喉眼学报, 2020,34(1): 67-71. doi:10.6040/j.issn.1673-3770.0.2019.349. SHEN Min, QU Jining, JIANG Yidao. Evaluation the efficacy of a CO2 laser and traditional exfoliation in the treatment of vocal cord leukoplakia by using objective voice analysis[J]. J Otolaryngol Ophthalmol Shandong Univ, 2020,34(1): 67-71. doi:10.6040/j.issn.1673-3770.0.2019.349. [5] 刘雪莱, 李明红, 周诗侗, 等. 功能性发声障碍职业用嗓者嗓音训练前后嗓音音域图及声学分析研究[J]. 听力学及言语疾病杂志, 2020, 28(1): 24-27. doi:10.3969/j.issn.1006-7299.2020.01.006. LIU Xuelai, LI Minghong, ZHOU Shidong, et al. Changes of the voice range profile and acoustic parameters beforeand after vocal training for professional voice user[J]. J Audiol Speech Pathol, 2020, 28(1): 24-27. doi:10.3969/j.issn.1006-7299.2020.01.006. [6] 徐丹, 刘雪莱, 周诗侗, 等. 职业用嗓人群音域图和嗓音疲劳测试分析[J]. 中国现代医学杂志, 2019, 29(10): 58-61. doi:10.3969/j.issn.1005-8982.2019.10.011. XU Dan, LIU Xuelai, ZHOU Shitong, et al. Application of voice range profile and voice fatigue test in evaluating the voice function of occupational voice users[J]. China J Mod Med, 2019, 29(10): 58-61. doi:10.3969/j.issn.1005-8982.2019.10.011. [7] 曹媛, 张奇雪, 阮宏莹, 等. 声带占位病变患者多维嗓音声学分析及发声空气动力学检测比较[J]. 听力学及言语疾病杂志, 2019, 27(3): 280-284. doi:10.3969/j.issn.1006-7299.2019.03.011. CAO Yuan, ZHANG Qixue, RUAN Hongying, et al. Multidimensional voice acoustic analysis and vocal aerodynamics of patients with vocal cord occupying lesions[J]. J Audiol Speech Pathol, 2019, 27(3): 280-284. doi:10.3969/j.issn.1006-7299.2019.03.011. [8] Solomon NP. Vocal fatigue and its relation to vocal hyperfunction ?[J]. Int J Speech Lang Pathol, 2008, 10(4): 254-266. doi:10.1080/14417040701730990. [9] Ilomäki I, Kankare E, Tyrmi J, et al. Vocal fatigue symptoms and laryngeal status in relation to vocal activity limitation and participation restriction[J]. J Voice, 2017, 31(2): 248.e7-248248.e10. doi:10.1016/j.jvoice.2016.07.025. [10] Stemple JC, Thomas LB. Column vocal health and hydration: fact or fiction?[J]. Voice Speech Rev, 2007, 5(1): 317-319. doi:10.1080/23268263.2007.10769780. [11] Hunter EJ, Banks RE. Gender differences in the reporting of vocal fatigue in teachers as quantified by the vocal fatigue index[J]. Ann Otol Rhinol Laryngol, 2017, 126(12): 813-818. doi:10.1177/0003489417738788. [12] Stappenbeck LE, Bohlender JE, Brockmann-Bauser M. Pretesting of the German Vocal Fatigue Index(VFI-D)-transcultural translation and cross validation[J]. HNO, 2020, 68(1): 48-54. doi:10.1007/s00106-019-00779-y. [13] Nanjundeswaran C, Jacobson BH, Gartner-Schmidt J, et al. Vocal fatigue index(VFI): development and validation[J]. J Voice, 2015, 29(4): 433-440. doi:10.1016/j.jvoice.2014.09.012. [14] Zambon F, Moreti F, Nanjundeswaran C, et al. Cross-cultural adaptation of the Brazilian version of the Vocal Fatigue Index-VFI[J]. CoDAS, 2017, 29(2): e20150261. doi:10.1590/2317-1782/20172015261. [15] Naderifar E, Moradi N, Farzadi F, et al. Cross-cultural adaptation and validation of the vocal fatigue index into Persian[J]. J Voice, 2019, 33(6): 947.e35-947.e41. doi:10.1016/j.jvoice.2018.07.024. [16] 李艳, 葛平江, 彭莉佳, 等. 嗓音训练治疗声带小结的疗效观察[J]. 听力学及言语疾病杂志, 2015, 23(3): 261-264. doi:10.3969/j.issn.1006-7299.2015.03.13. LI Yan, GE Pingjiang, PENG Lijia, et al. The effects of voice training therapy on dysphonia in patients with vocal nodules[J]. J Audiol Speech Pathol, 2015, 23(3): 261-264. doi:10.3969/j.issn.1006-7299.2015.03.13. [17] 迟晨雨, 王嘉玺, 刘大新. 嗓音训练对用声过度嗓音疾病患者的疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(4): 307-309. doi:10.13201/j.issn.1001-1781.2017.04.015. CHI Chenyu, WANG Jiaxi, LIU Daxin. Effectiveness of voice training for the patients with excessive use sound and voice disorders[J]. J Clin Otorhinolaryngol Head Neck Surg, 2017, 31(4): 307-309. doi:10.13201/j.issn.1001-1781.2017.04.015. [18] 郝艳, 李栋才, 蓝建平. CO2激光显微手术与传统显微手术切除声带息肉疗效比较[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 68-70. doi:10.6040/j.issn.1673-3770.0.2017.034. HAO Yan, LI Dongcai, LAN Jianping. Comparison of the curative effect of CO2 laser microsurgery and conventional microsurgery for vocal polyp resec-tion[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(6): 68-70. doi:10.6040/j.issn.1673-3770.0.2017.034. [19] 欧阳杰, 黄永望, 高晓葳, 等. 手术联合围手术期嗓音训练治疗声带息肉的疗效分析[J]. 听力学及言语疾病杂志, 2018, 26(5): 492-495. doi:10.3969/j.issn.1006-7299.2018.05.010. OUYANG Jie, HUANG Yongwang, GAO Xiaowei, et al. The clinical efficacy of voice training on patients with vocal cord polyps during perioperative period[J]. J Audiol Speech Pathol, 2018, 26(5): 492-495. doi:10.3969/j.issn.1006-7299.2018.05.010. [20] 陈闽琪, 彭文静, 陈舒华. 阿克森疗法对声带息肉术后嗓音恢复的疗效探讨[J]. 山东大学耳鼻喉眼学报, 2014(6): 61-64. doi:10.6040/j.issn.1673-3770.0.2014.125. CHEN Minqi, PENG Wenjing, CHEN Shuhua. Evaluation of akson therapy after vocal polyp surgery[J]. J Otolaryngol Ophthalmol Shandong Univ, 2014(6): 61-64. doi:10.6040/j.issn.1673-3770.0.2014.125. [21] 赵艳, 程四华, 童巧珍. 强化自我护理对喉镜辅助声带息肉切除术后患者嗓音恢复及心理情绪的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 175-178. doi:10.6040/j.issn.1673-3770.0.2018.386. ZHAO Yan, CHENG Sihua, TONG Qiaozhen. Effects of intensive self-care on voice recovery and psychological emotions in patients undergoing laryngoscope-assisted vocal cord polypectomy[J]. J Otolaryngol Ophthalmol Shandong Univ, 2019, 33(4): 175-178. doi:10.6040/j.issn.1673-3770.0.2018.386. |
[1] | 刘洪, 王娟, 王春娇. 喉米枯力兹(Mikulicz)病1例[J]. 山东大学耳鼻喉眼学报, 2014, 28(6): 100-100. |
[2] | 王丽 . 雾化吸入联合理疗治疗声带小结60例[J]. 山东大学耳鼻喉眼学报, 2009, 23(1): 74-75 . |
[3] | 吴治钦 . 声带小结、声带息肉823例手术分析[J]. 山东大学耳鼻喉眼学报, 2007, 21(6): 572-573 . |
|