CAJ | 학술논문

目的探讨空气动力学参数在嗓音功能评估中的应用及意义.方法采用言语发声空气动力学测试系统对正常嗓音、声带息肉、声带囊肿和声带运动障碍患者进行空气动力学参数采集并统计分析.结果 100例正常嗓音组的发声阈气流(phonation threshold flow,PTF)、平均气流率(mean flow rate,MFR)、最长发声时间(maximum phonation time,MPT)和声门阻力(glottal resistance,GR)等气流相关参数的性别差异有统计学意义(P值均＜0.05),而发声阈压(phonation threshold pressure,PTP)、声门下压(subglottal pressure,SGP)和发音效率(vocal efficiency,VE)等压力相关参数性别差异无统计学意义(P值均＞0.05).113例嗓音疾病患者除了GR和VE外,其他参数与正常对照组差异均有统计学意义(P值均＜0.05),而在嗓音疾病组间差异无统计学意义(P值均＞0.05).ROC曲线分析显示除GR外的其他参数均有临床诊断价值,以PTP的诊断价值最大.嗓音障碍程度不同的声带息肉患者空气动力学参数差异均无统计学意义(P值均＞0.05),而41例声带息肉术后患者除了GR和VE外的其他参数均较术前变化,差异有统计学意义(P值均＜0.05).结论空气动力学参数能客观有效评估嗓音功能变化,具有良好的辅助诊断价值.
목적 탐토공기동역학삼수재상음공능평고중적응용급의의.방법 채용언어발성공기동역학측시계통대정상상음、성대식육、성대낭종화성대운동장애환자진행공기동역학삼수채집병통계분석.결과 100례정상상음조적발성역기류(phonation threshold flow,PTF)、평균기류솔(mean flow rate,MFR)、최장발성시간(maximum phonation time,MPT)화성문조력(glottal resistance,GR)등기류상관삼수적성별차이유통계학의의(P치균＜0.05),이발성역압(phonation threshold pressure,PTP)、성문하압(subglottal pressure,SGP)화발음효솔(vocal efficiency,VE)등압력상관삼수성별차이무통계학의의(P치균＞0.05).113례상음질병환자제료GR화VE외,기타삼수여정상대조조차이균유통계학의의(P치균＜0.05),이재상음질병조간차이무통계학의의(P치균＞0.05).ROC곡선분석현시제GR외적기타삼수균유림상진단개치,이PTP적진단개치최대.상음장애정도불동적성대식육환자공기동역학삼수차이균무통계학의의(P치균＞0.05),이41례성대식육술후환자제료GR화VE외적기타삼수균교술전변화,차이유통계학의의(P치균＜0.05).결론 공기동역학삼수능객관유효평고상음공능변화,구유량호적보조진단개치.
Objective To investigate the application and significance of aerodynamic parameters in voice function assessment. Methods The phonatory aerodynamic system (PAS) was used to collect aerodynamic parameters from subjects with normal voice,vocal fold polyp,vocal fold cyst,and vocal fold immobility.Multivariate statistical analysis was used to compare measurements across groups. Results Phonation threshold flow ( PTF),mean flow rate (MFR),maximum phonation time ( MPT),and glottal resistance (GR) in one hundred normal subjects were significantly affected by sex ( P ＜ 0.05 ),while phonation threshold pressure (PTP),subglottal pressure (SGP),and vocal efficiency (VE) were not (P ＞0.05). PTP,PTF,MFR,SGP,and MPT were significantly different between normal voice and voice disorders (P ＜ 0.01 ),and there were no significant differences among the three disorders ( P ＞ 0.05 ).Receiver operating characteristic (ROC) analysis found that PTP,PTF,SGP,MFR,MPT,and VE in one hundred thirteen voice dis orders had similar diagnostic utility (P ＜0.01 ),with PTP exhibiting the highest area under the curve.The aerodynamic parameters of the three degrees of voice dysfunction due to vocal cord polyps were compared and found to have no significant differences(P ＞0.05).PTP,PTF,MFR,SGP and MPT in forty one patients with vocal polyps were significantly different after surgical resection of vocal cord polyps (P ＜ 0.01 ).Conclusion The aerodynamic parameters can objectively and effectively evaluate the variations of vocal function,and have good auxiliarv diagnostic value.