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目的:研究儿童腺样体切除术对腭咽闭合功能的早期及长期影响。方法:对行腺样体切除术的患儿分别于术前、术后1周、1个月及3个月进行患儿父母或陪护人员调查问卷、吹泡试验及计算机语音声学分析。结果:①患儿父母或陪护人员调查问卷显示,31例中有22例术后有鼻音增高的改变,有9例术后3个月此症状仍存在。有7例术后出现鼻腔食物反流,且均同时有鼻音增高,但鼻腔食物反流全部于术后1个月内消失。②吹泡试验反映术后1周内患儿存在腭咽闭合功能不全(P<0.01),术后1、3个月差异均无统计学意义(均P<0.05)。③计算机语音声学分析结果显示,患者术后短期内出现辅音残缺、元音共振峰残缺和鼻化音的异常语图表现,术后3个月时基本恢复正常;术后/i:/音F3峰值与术前相比降低,尤其是术后1周时F3峰值降低最明显(P<0.01)。结论:儿童腺样体切除术后大部分儿童可出现一过性腭咽闭合功能不全的表现,但未见其对腭咽闭合功能有长期的影响。
Objective: To study the early and long-term effects of adenotonsillectomy on velopharyngeal closure in children. Methods: Questionnaire, blister test and computer acoustics analysis were conducted on children with adenoidectomy undergoing surgery, 1 week, 1 month and 3 months after operation. Results: (1) The questionnaire of children’s parents or caretakers showed that in 31 cases, 22 cases had the change of nasal tone after operation, and 9 cases still existed after 3 months. There were 7 cases of postoperative reflux of nasal food, and both have increased nasal, nasopharyngeal food reflux but all disappear within 1 month after surgery. ② The blister test showed that the patients had velopharyngeal insufficiency within 1 week after operation (P <0.01). There was no significant difference at 1 and 3 months after operation (all P <0.05). Computer acoustics analysis showed that patients had short consonants, shortcomings of vowel resonance and nasal abnormal voice abnormalities, and basically returned to normal after 3 months; postoperative / i: / tone F3 The peak value decreased compared with that before operation, especially the peak value of F3 decreased most obviously after 1 week (P <0.01). CONCLUSIONS: Most children underwent adenotonsillectomy may have transient velopharyngeal insufficiency, but no long-term effects on velopharyngeal closure have been observed.