声带良性增生性病变教师嗓音主客观评估及危险因素分析

摘要

目的 利用主客观评估声带良性增生性病变教师的嗓音质量,分析其嗓音障碍的危险因素.方法 选取98例声带良性增生性病变教师为嗓音障碍(VD)组,同期就诊无声带良性增生性病变102例教师为非嗓音障碍(NVD)组,利用嗓音声学分析、嗓音障碍指数量表及声带良性增生性病变教师危险因素调查问卷对可能的危险因素进行搜集整理,进行Logistic回归分析.结果 VD组嗓音声学参数基频微扰和振幅微扰显著高于NVD组,嗓音障碍严重指数和最长发音时间显著低于NVD组,嗓音障碍指数量表功能、生理和情感评分均显著高于NVD组(均P＜0.05);教龄、职业层次、平均课时数、课堂学生数、吸烟量、饮酒量、辛辣刺激食物等为教师声带良性增生性病变的独立危险因素(P＜0.05,P＜0.01).结论 教师声带良性增生性病变包括多个危险因素,嗓音主客观联合评估能全面评价教师患者的嗓音质量.%Objective To assess the voice quality subjectively and objectively for teachers with vocal cords' benign proliferative lesions,and to analyze the risk factors of voice disorders.Methods A total of 98 teachers with vocal cords' benign proliferative lesions were regarded as a voice disorders (VD) group,and 102 teachers without vocal cords' benign proliferative lesions at the same time were selected as a non-voice disorders (NVD) group.Then voice acoustic analysis,voice handicap index and vocal cord benign proliferative lesion risk factors for teachers questionnaire were utilized to collect the possible risk factors through logistic regression a nalysis.Results The voice acoustic parameters jitter and shimmer of the VD group were significantly higher than those of the NVD group,dysphonia severity index and maximum phonation time were significantly lower than those of the NVD group,and the score of function,physiology and emotion of the VHI scale were significantly higher than those of the NVD group(P＜0.05 for all).Teaching years,vocational level,average classes,number of students in class,amount of smoking,amount of alcohol drinking,spicy food etc were independent risk factors for teachers with vocal cords' benign proliferative lesions(P＜0.05,P＜0.01).Conclusion The vocal cords' benign proliferative lesions of teachers includes multiple risk factors,and subjective combining with objective assessment can comprehensively evaluate voice quality of the teachers.