摘要
目的 观察喉肌电图联合嗓音训练在预后不良单侧声带麻痹中的早期应用,并通过嗓音声学评估判断其临床疗效。方法 选取2022年1月—2024年12月于河北医科大学第二医院耳鼻喉科就诊的早期声带麻痹患者82例为研究对象,喉镜检查患侧声带固定于旁正中位,喉肌电图提示声带麻痹预后不良,作为研究对象,根据随机对照原则分组,研究组接受16周的嗓音训练,对照组不接受任何干预治疗。所有患者在训练前及入组后第8周、12周、16周进行了喉镜检查、嗓音声学评估。结果 经过16周嗓音训练,研究组在主观听感知评估量表各维度评分(总嘶哑度、粗糙度、气息度、无力度、紧张度)及嗓音障碍指数量表各项得分(功能、生理、情感)及总分上均显著低于对照组(P<0.05)。电子喉镜显示,研究组声门闭合程度较对照组显著改善。随着训练时间的延长,2组基频微扰和振幅微扰越来越低,标准化噪声能量(normalized noise energy, NNE)逐渐增大,最长发声时间(maximum phonation time,MPT)逐渐延长,且研究组较对照组变化更明显,2组组间、时点间、组间·时点间交互作用比较差异有统计学意义(P<0.05)。结论 对于喉肌电图提示预后不良的单侧声带麻痹患者,早期进行正规的嗓音训练能有效改善患者的声门闭合情况及嗓音质量,可以降低预后不良单侧声带麻痹患者的手术需求。
Objective To observe the early application of laryngeal electromyography combined with voice training in the treatment of unilateral vocal cord paralysis(UVCP)with poor prognosis,and to evaluate its clinical efficacy through voice acoustic assessment.Methods A total of 82 patients with early vocal cord paralysis who visited the Department of Otolaryngology,the Second Hospital of Hebei Medical University from January 2022 to December 2024 were selected as the study subjects.Laryngoscopy revealed that the affected vocal cords were fixed in a midline position,and laryngeal electromyography indicated a poor prognosis for vocal cord paralysis.These subjects were grouped according to a randomized controlled principle,with the study group receiving 16 weeks of voice training and the control group receiving no intervention treatment.All patients underwent laryngoscopy and voice acoustic assessment before training,as well as at 8,12,and 16 weeks after enrollment.Results At 16 weeks after voice training,the study group exhibited significantly lower scores in all dimensions of the subjective auditory perception assessment scale(total hoarseness,roughness,breathiness,asthenia,and strain)as well as in the individual domain scores(functional,physical,and emotional)and the total score of the Voice Handicap Index compared with the control group(P<0.05).Electronic laryngoscopy revealed a significant improvement in the glottic closure degree of the study group compared with the control group.As training duration extended,both groups showed progressively lower fundamental frequency perturbation and amplitude perturbation,a gradual increase in NNE,and a gradual prolongation of MPT,with more pronounced changes in the study group.Significant differences were observed in the interactions between groups,time points,and between group and time points(P<0.05).Conclusion For patients with UVCP indicated by laryngeal electromyography to have a poor prognosis,early standardized voice training can effectively improve glottic closure and voice quality,and may reduce the need for surgical intervention.
作者
温鑫
杨志超
王珊珊
冯心宁
边艳蕊
王静妙
WEN Xin;YANG Zhi-chao;WANG Shan-shan;FENG Xin-ning;BIAN Yan-rui;WANG Jing-miao(Department of Otolaryngology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《河北医科大学学报》
2026年第3期330-334,共5页
Journal of Hebei Medical University
关键词
声带麻痹
喉肌电图
嗓音训练
早期干预
vocal cord paralysis
laryngeal electromyography
voice training
early intervention
