山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (3): 54-58.doi: 10.6040/j.issn.1673-3770.0.2020.407
马亦飞1,喻国冻1,鲜志芃1,何星辰1,顾萍1,陈自力2
MA Yifei1, YU Guodong1, XIAN Zhipeng1, HE Xingchen1, GU Ping1, CHEN Zili2
摘要: 目的 探讨嗓音训练应用于声带息肉术后的疗效。 方法 选取92例接受声带息肉切除术患者作为研究对象,所有患者随机分为实验组(n=46)与对照组(n=46)两组。两组患者均行喉显微声带息肉切除术,对照组术后给予金嗓散结丸口服治疗4周,实验组在对照组基础上术后1周起联合嗓音训练治疗3周,术后4周两组同时结束治疗。比较两组患者治疗前后嗓音障碍指数(VHI)评分及嗓音声学参数值。 结果 脱落病例6例,86例完成研究。治疗前实验组与对照组VHI评分及嗓音声学参数值差异无统计学意义(P>0.05);治疗后两组VHI评分及嗓音声学参数值较治疗前均改善(P<0.001);治疗后实验组较对照组VHI评分及嗓音声学参数值显著改善。 结论 嗓音训练可促进声带术后功能恢复,提高嗓音质量,疗效显著。
中图分类号:
| [1] 尤慧华, 诸葛盼, 王翰青, 等. 声带息肉患者的主客观嗓音评估特征[J]. 听力学及言语疾病杂志, 2016, 24(1): 85-87. doi:10.3969/j.issn.1006-7299.2016.01.021. [2] Lin YH, Wang CT, Lin FC, et al. Treatment outcomes and adverse events following in-office angiolytic laser with or without concurrent polypectomy for vocal fold polyps[J]. JAMA Otolaryngol Head Neck Surg, 2018, 144(3): 222-230. doi:10.1001/jamaoto.2017.2899. [3] 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. [4] 秦辉. 支撑喉镜和纤维喉镜下声带息肉切除术疗效分析[J]. 中国耳鼻咽喉头颈外科, 2016,23(8): 487-489. doi:10.16066/j.1672-7002.2016.08.012. QIN Hui. Clinical effects of vocal cord polyp surgery under micro-laryngoscope and fiberoptic laryngoscope[J]. Chin Arch Otolaryngol-Head Neck Surg, 2016, 23(8): 487-489. doi:10.16066/j.1672-7002.2016.08.012. [5] 汤苏成, 王跃建, 陈伟雄, 等. 声带息肉和小结术后发声障碍患者嗓音训练疗效观察[J]. 听力学及言语疾病杂志, 2017, 25(2): 200-202. doi:10.3969/j.issn.1006-7299.2017.02.018. [6] 罗轶, 阚丹, 周琦, 等. 嗓音训练在发声不当所致嗓音疾病患者中的疗效[J]. 广西医学, 2020, 42(11): 1354-1357,1372. doi:10.11675/j.issn.0253-4304.2020.11.05. LUO Yi, KAN Dan, ZHOU Qi, et al. Efficacy of voice training for patients with voice disorders caused by improper vocalization[J]. Guangxi Med J, 2020, 42(11): 1354-1357,1372. doi:10.11675/j.issn.0253-4304.2020.11.05. [7] 韩德民, Sataloff RT, 徐文. 嗓音医学[M]. 2版. 北京: 人民卫生出版社, 2017: 203-205. [8] 刘阳, 黄永望, 潘静, 等. 四步训练嗓音矫治法在声带息肉术后的应用及体会[J]. 中国中西医结合耳鼻咽喉科杂志, 2019, 27(4): 259-263. doi:10.16542/j.cnki.issn.1007-4856.2019.04.005. LIU Yang, HUANG Yongwang, PAN Jing, et al. Application of four steps method about voice therapy on patients with vocal polyps after surgery[J]. Chin J Otorhinolaryngol Integr Med, 2019, 27(4): 259-263. doi:10.16542/j.cnki.issn.1007-4856.2019.04.005. [9] 于萍. 发声训练在嗓音疾病治疗中的价值[J]. 中国中西医结合耳鼻咽喉科杂志, 2019, 27(4): 241-245. doi:10.16542/j.cnki.issn.1007-4856.2019.04.001. [10] 徐文, 李红艳, 胡蓉, 等. 嗓音障碍指数量表中文版信度和效度评价[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43(9): 670-675. doi:10.3321/j.issn: 1673-0860.2008.09.008. XU Wen, LI Hongyan, HU Rong, et al. Analysis of reliability And validity of the Chinese version of voice handicap index(VHI)[J]. Chin J Otorhinolaryngol Head Neck Surg, 2008, 43(9): 670-675. doi:10.3321/j.issn: 1673-0860.2008.09.008. [11] 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): 67-70. doi:10.60640/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): 67-70. doi:10.60640/j.issn.1673-3770.0.2019.349. [12] Vasconcelos D, Gomes AOC, Araújo CMT. Vocal fold polyps: literature review[J]. Int Arch Otorhinolaryngol, 2019, 23(1): 116-124. doi:10.1055/s-0038-1675391. [13] 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. [14] 屈凤勤, 李海霞, 李梅生, 等. 声带息肉围手术期嗓音训练的临床疗效分析[J]. 中国耳鼻咽喉头颈外科, 2017,24(3): 156-158. doi:10.16066/j.1672-7002.2017.03.012. QU Fengqin, LI Haixia, LI Meisheng, et al. Clinical efficacy of voice training in the perioperative period of vocal cord polyp[J]. Chin Arch Otolaryngol-Head Neck Surg, 2017,24(3): 156-158. doi:10.16066/j.1672-7002.2017.03.012. [15] Sahin M, Gode S, Dogan M, et al. Effect of voice therapy on vocal fold polyp treatment[J]. Eur Arch Otorhinolaryngol, 2018, 275(6): 1533-1540. doi:10.1007/s00405-018-4962-z. [16] Barillari MR, Volpe U, Mirra G, et al. Surgery or rehabilitation: a randomized clinical trial comparing the treatment of vocal fold polyps via phonosurgery and traditional voice therapy with “voice therapy expulsion” training[J]. J Voice, 2017, 31(3): 379.e13-379.e20. doi:10.1016/j.jvoice.2016.07.002. [17] 诸葛盼, 尤慧华, 王翰青, 等. 嗓音治疗对声带息肉患者嗓音显微手术后的疗效观察[J]. 中华全科医学, 2016,14(8): 1275-1278. doi:10.16766/j.cnki.issn.1674-4152.2016.08.010. ZHUGE Pan, YOU Huihua, WANG Hanqing, et al. The clinical effectiveness of voice therapy on patients with vocal cord polyps after phonomicrosurgery[J]. Chin J Gen Pract, 2016,14(8): 1275-1278. doi:10.16766/j.cnki.issn.1674-4152.2016.08.010. [18] Petrovic-Lazic M, Jovanovic N, Kulic M, et al. Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy[J]. J Voice, 2015, 29(2): 241-246. doi:10.1016/j.jvoice.2014.07.009. [19] Zhuge P, You HH, Wang HQ, et al. An analysis of the effects of voice therapy on patients with early vocal fold polyps[J]. J Voice, 2016, 30(6): 698-704. doi:10.1016/j.jvoice.2015.08.013. [20] 黄永望, 傅德慧, 潘静. 实用临床嗓音疾病矫治学[M]. 天津: 天津科技翻译出版有限公司, 2018: 337-393. [21] 林玲玲, 林少雄, 程耿斌, 等. 声带息肉术后嗓音训练配合中医针药治疗的疗效观察[J]. 中国医药科学, 2016, 6(8): 12-14. LIN Lingling, LIN Shaoxiong, CHENG Gengbin, et al. Effect of vocal training combined with traditional Chinese acupuncture and medicine in the patients after vocal cord polyp resection surgeries[J]. China Med Pharm, 2016, 6(8): 12-14. [22] Agarwal J, Wong A, Karle W, et al. Comparing short-term outcomes of surgery and voice therapy for patients with vocal fold polyps[J]. Laryngoscope, 2019, 129(5): 1067-1070. doi:10.1002/lary.27697. [23] 陈志鹏, 熊姗姗, 李美丽, 等. 声带显微手术后发声功能恢复和嗓音训练时间的初步探讨[J]. 中国医学创新, 2015, 12(16): 39-41. doi:10.3969/j.issn.1674-4985.2015.16.014. CHEN Zhipeng, XIONG Shanshan, LI Meili, et al. Preliminary study on functional recovery and voice training time after microsurgical operation of vocal cords[J]. Med Innov China, 2015, 12(16): 39-41. doi:10.3969/j.issn.1674-4985.2015.16.014. [24] 刘一贞, 秦勇, 李嘉, 等. 声带显微微瓣手术后发声功能恢复和嗓音训练时间的分析[J]. 延安大学学报(医学科学版), 2016, 14(2): 41-43. doi:10.3969/j.issn.1672-2639.2016.02.013. LIU Yizhen, QIN Yong, LI Jia, et al. Analyzing time of functional recovery and vocal training after phonomicrosurgery[J]. J Yanan Univ Med Sci, 2016, 14(2): 41-43. doi:10.3969/j.issn.1672-2639.2016.02.013. [25] 洪拥军, 徐新林, 林生智, 等. 声带显微微瓣手术后发声功能恢复和嗓音训练时间的初步探讨[J]. 听力学及言语疾病杂志, 2012, 20(5): 417-419. doi:10.3969/j.issn.1006-7299.2012.05.003. HONG Yongjun, XU Xinlin, LIN Shengzhi, et al. The observation of vocal polyp by phonomicrosurgery and vocal fold recovery[J]. J Audiol Speech Pathol, 2012, 20(5): 417-419. doi:10.3969/j.issn.1006-7299.2012.05.003. |
| [1] | 方璐, 雷玉丹, 王华. 环孢素滴眼液联合玻璃酸钠滴眼液治疗干眼临床效果的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 65-73. |
| [2] | 雷玉丹,方璐,陈健,彭昌福. 托珠单抗治疗激素抵抗或不耐受的中重度甲状腺相关性眼病临床疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 54-67. |
| [3] | 朱明琼,李征,刘茹,田涛,彭婧利,吕倩怡,谭华霞. 基于OCT/OCTA的AI筛查系统在抗VEGF治疗糖尿病性黄斑水肿患者效果评价中的应用[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 68-73. |
| [4] | 孙庆祝,沈健,陈星,吴雁冰,曾论. 代谢指标在预测糖尿病性黄斑水肿患者雷珠单抗疗效中的作用[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 74-81. |
| [5] | 刘梓琪,黄佳丽,汪李琴,陈曦,张立庆,周涵. 窄带成像内镜联合嗓音声学分析在声带白斑鉴别诊断中的价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 87-96. |
| [6] | 刘怡君,谷悦,官大宇,杨玉成,沈暘. 翼管神经切断术在难治性变应性鼻炎中远期临床疗效和安全性[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 42-48. |
| [7] | 孙春晓,王文晴,岳田,刘济生. 高低累积顺铂剂量同步放化疗治疗鼻咽癌的疗效分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 31-41. |
| [8] | 郑泽皓,魏佳俐,刘嘉涛,周玉麒,孙文婷,李雨轩,白鹏. 特定部位针刺法治疗突发性聋的疗效及安全性评价:一项系统综述和网状Meta分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 114-127. |
| [9] | 邹嵩,许保源,张金星,陈巧婷,李健祥. ABCLOVE嗓音训练法对声带良性增生性病变手术患者嗓音功能的影响[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 32-37. |
| [10] | 王鑫,原晶晶,郝鹏鹏,闫占峰,刘建华,钟利群,刘思溟,吴薇,赵晓阳,张莹. 中药复方治疗突发性聋的疗效和可能机制:一项结合网络药理学研究的回顾性临床分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 6-17. |
| [11] | 周静琳,李金香,曾琦. 577 nm阈值下微脉冲激光联合抗VEGF药物治疗难治性糖尿病性黄斑水肿的疗效观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 18-25. |
| [12] | 王婷玉,吕正华,韩茜茜,孙臻,张海燕,徐伟. 单侧声带麻痹为首发症状的甲状旁腺腺瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 59-65. |
| [13] | 徐宏鸣,范文焱,浦诗磊,李晓艳. 儿童上颌窦后鼻孔息肉36例临床资料分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 159-163. |
| [14] | 王晓嫒,张欠欠,程翔宇,李志鹏,张维天,叶海波. 翼管神经切断术治疗2型慢性鼻窦炎伴过敏性鼻炎的临床疗效分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 42-49. |
| [15] | 刘楠,逄明杰. 鼻内镜泪囊鼻腔吻合术预后影响因素的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 149-155. |
|
||