CAJ | 학술논문

目的：探讨手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效。方法117例伴肌紧张性发声障碍的声带息肉患者分为单纯手术组（手术组，57例）和手术联合嗓音训练组（联合组，60例），另随机选取50例无嗓音疾患的正常人作为正常对照组。采用Xion声学分析软件对正常对照组及手术组、联合组患者治疗前后的嗓音基频微扰（jitter）、振幅微扰（shimmer）、嗓音障碍指数（DSI）进行测试并比较。结果手术组、联合组治疗后jitter和shimmer值均较治疗前明显降低，DSI明显升高（P＜0．05），而联合组的jitter和shimmer值更低，DSI值更高（P＜0．05）；手术组治疗后的jitter和shimmer值高于正常组，DSI值低于正常组（P＜0．05）；联合组治疗后jit‐ter和shimmer与正常组比较差异无统计学意义（P＞0．05）。结论喉显微外科手术联合嗓音训练有助于提高伴肌紧张性发声障碍声带息肉患者手术后的嗓音质量。
목적：탐토수술연합상음훈련대반기긴장성발성장애성대식육환자적료효。방법117례반기긴장성발성장애적성대식육환자분위단순수술조（수술조，57례）화수술연합상음훈련조（연합조，60례），령수궤선취50례무상음질환적정상인작위정상대조조。채용Xion성학분석연건대정상대조조급수술조、연합조환자치료전후적상음기빈미우（jitter）、진폭미우（shimmer）、상음장애지수（DSI）진행측시병비교。결과수술조、연합조치료후jitter화shimmer치균교치료전명현강저，DSI명현승고（P＜0．05），이연합조적jitter화shimmer치경저，DSI치경고（P＜0．05）；수술조치료후적jitter화shimmer치고우정상조，DSI치저우정상조（P＜0．05）；연합조치료후jit‐ter화shimmer여정상조비교차이무통계학의의（P＞0．05）。결론후현미외과수술연합상음훈련유조우제고반기긴장성발성장애성대식육환자수술후적상음질량。
Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia (MTD) .Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD .All the patients were divided into two groups ac‐cording to the different remedies:the surgery group (n=57) ,and the combination group (n=60) .The Xion acous‐tic analysis was carried out on the two groups before and after therapy .We compared the results in each group ,the results of post-therapy between two groups ,and that of post-therapy with the control group(n=50) .The acous‐tic parameters were jitter percent (jitter) ,shimmer percent (shimmer) ,dysphonia severity index (DSI) .Results The results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group(P<0 .05) .Jitter and shimmer in post -therapeutic out‐come of the combination group were lower than those of in surgery group ,and DSI was even higher(P<0 .05) .Jit‐ter and shimmer in post-therapeutic outcome of surgery group were higher than those of in normal group ,and DSI was lower than those of in normal group(P<0 .05) .But there were no clinically significant differences in post -therapeutic outcomes of combination group compared with control group(P>0 .05) .Conclusion As for vocal polyps accompanied with M TD ,successful phonosurgical treatment and voice therapy can improve patients’ voice quality .