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目的比较早期声带息肉患者发声训练与嗓音显微手术的疗效,总结临床治疗经验。方法选取2013年9月—2015年2月金华市中心医院就诊的早期声带息肉患者69例,分为嗓音组和手术组。嗓音组38例患者进行持续时间约3个月的发声训练与嗓音保健教育,应用动态喉镜、嗓音障碍指数量表(voice handicap index,VHI)、嗓音障碍严重指数(dysphonia severity index,DSI)评估疗效。手术组31例患者选择嗓音显微手术,术后嗓音保健教育,随访评估疗效。应用SPSS 15.0统计软件,比较发声训练和嗓音显微手术的临床疗效,P<0.05为差异有统计学意义。结果嗓音组治愈率为31.6%,手术组治愈率为100%。Mann-Whitney U检验分析,手术组治愈率要优于嗓音组(Z=-5.792,P<0.001)。组内配对样本t检验分析,2组治疗后的VHI值及最长发声时间(MPT)、基频微扰(Jitter)、最高音频(F0-High)、最低声强(I-Low)、DSI值均较治疗前改善。组间独立样本t检验分析,嗓音组的E值、MPT、Jitter、DSI值改善程度优于手术组。结论无论嗓音显微手术还是发声训练,都能改善早期声带息肉患者的嗓音质量,并各自体现不同的优越性。
Objective To compare the efficacy of vocal training and vocal microsurgery for vocal cord polyps in early stage and to summarize the experience of clinical treatment. Methods From September 2013 to February 2015, 69 patients with early vocal cord polyps who were treated in Jinhua Central Hospital were divided into vocal group and operation group. Thirty-eight patients in the vocal group received vocal training and vocal health education for approximately 3 months. Dynamic laryngoscopy, voice handicap index (VHI), and dysphonia severity index (DSI) were assessed Efficacy. Surgical group of 31 patients selected voice microsurgery, postoperative voice health education, follow-up evaluation of the effect. SPSS15.0 statistical software was used to compare the clinical efficacy of vocal training and voice microsurgery, P <0.05 for the difference was statistically significant. Results The voice group cure rate was 31.6%, surgical group cure rate was 100%. Mann-Whitney U test analysis, the cure rate was better than voice group (Z = -5.792, P <0.001). The results of paired samples t-test showed that VHI, MPT, Jitter, I-Low, DSI, Value than before treatment to improve. Independent t-test between groups showed that E value, MPT, Jitter and DSI in voice group were better than those in operation group. Conclusion Vocal microsurgery or vocal training can improve the vocal quality of patients with early vocal cord polyps and show different advantages.