儿童声带小结嗓音声学参数分析及非手术治疗效果评估

摘要

Objective To study acoustic parameters of children's vocal nodules,to analyze the acoustic characteristics and differences of children's vocal nodules before and after treatment and to provide theoretical basis for the quantitative evaluation of voice improvement in children with vocal nodules after treatment by using voice parameters.Methods Forty-five cases of vocal nodules diagnosed by stroboscopic laryngoscope were selected as the treatment group,and 45 normal children as control group.Multidimensional speech analysis was carried out by computer speech station 4150B type speech analysis system.Results Among children with vocal nodules after 2 weeks' non-surgical treatment,26 cases were cured,11 cases got better,8 patients were improved.In treatment group before and after treatment,fundamental frequency(Fo),highest fundamental frequency(Fhi),Jita,Jitter,Shimmer,amplitude perturbation quotient (APQ),noise to harmonic ratio(NHR) were higher than that in the cortrol group.In treatment group after treatment,Jita,Jitter,Shimmer,APQ,NHR were lower than the group before treatment,the difference was statistically significant (P＜0.05).Conclusion The acoustic parameters of vocal nodules in children can be evaluated objectively by computer voice acoustic testing,which can be used to evaluate the therapeutic effect of vocal nodules in children.The voice acoustic parameters of children with vocal nodules are significantly different from those of normal children.Children with vocal nodules of vocal training and voice rehabilitation is of great significance to improve children's voice quality,training and drug treatment combined with voice can improve the patient's pronunciation function,which is worthy of promotion.%目的 研究儿童声带小结的客观声学参数值,分析儿童声带小结治疗前后的嗓音声学特点及差异,为临床应用嗓音参数定量评价声带小结患儿治疗后嗓音改善情况提供理论依据.方法 选择经频闪喉镜确诊的声带小结患儿45例作为治疗组,正常儿童45例作为对照组.应用计算机语音工作站4150B型言语分析系统进行多维嗓音分析.结果 声带小结患儿非手术治疗2周后治愈26例,有效11例,好转8例.治疗组治疗前后基频(fundamental frequency,Fo)、最高基频(highest fundamental frequency,Fhi)、绝对音调微扰(Jita)、基频微扰(Jitter)、振幅微扰(Shimmer)、振幅扰动商(amplitude perturbation quotient,APQ)、噪声/谐和比(noise to harmonic ratio,NHR)均高于对照组,治疗组治疗后Jita、Jitter、Shimmer、APQ、NHR均低于治疗前,差异有统计学意义(P＜0.05).结论 计算机嗓音声学检测得出儿童声带小结的各项声学参数值可为儿童声带小结治疗效果作出客观评价.声带小结患儿的嗓音声学参数与正常儿童嗓音相比有明显差异.对声带小结患儿进行发声训练及嗓音康复指导可改善患儿嗓音质量,有重要意义,将嗓音训练与药物治疗相结合,能够改善患儿的发音功能,值得推广.