小学教师嗓音质量评估的研究

目的探讨嗓音声学分析与嗓音障碍指数（voicehandicapindex，VHI）用于小学教师嗓音质量评估的临床意义。方法30例嗓音正常教师（G1组）与同一学校年龄、性别、教龄相匹配的30例嗓音障碍教师（G2组）均行间接喉镜检查、嗓音声学分析、V…量表自我评估，两组结果进行比较分析。结果嗓音障碍组（G2）中慢性喉炎占77％（23／30）、声带息肉占1O％（3／30）。声带小结占13％（4／30）。嗓音障碍组（G2）的Jitter．Shimmer、噪谐比（NHR）均高于嗓音正常组（G1），差异有统计学意义（p〈o．05）。嗓音障碍组（G2）与嗓音正常组（G1）的功能（functional，F）、生理（physical，P）．情感（emotional，E）三方面得分及VHI总分（totalscoresoftheVHl，Tvh）分值两组间差异有统计学意义（P〈0．05）。嗓音障碍组（G2）VHI量表中除E外，F、P、Tvh与Jitter、Shimmer、NHR之间有良好的相关性。结论临床上可以用嗓音声学分析中各项指标判断教师嗓音障碍的严重程度，VHI可主观反映教师嗓音疾病的严重程度，二者在嗓音质量评估中具有一定的临床应用价值。

The Voice Quality Assessment of Teachers at an Elementary School

Objective To explore the clinical significance of voice acoustic analysis（VAA） and the application of voice handicap index（VHI） in the voice assessment of teachers at elementary schools. Methods Thirty teachers with normal voice （Group 1） and thirty teachers with voice disorders of the same age, gender and school age （Group 2） received the indirect laryngoscope, VAA and VHI assessment. The results of the two groups were compared and analyzed. Results In Group 2, the percentage of chronic laryngitis was 77%（23/30）, vocal polyps 10%（3/30） and vocal nodules 13%（4/30）,respectively. The Jitter, Shimmer and NHR of Group 2 were higher than those of Group 1, showing significant differences（P〈0.05）.And there were significant differences in functional（F）, physical（P）, emotional（E） and total scores of VHI（Tvh） between Group 1 and Group 2（P〈0.05）. Except E, there were correlations between F, P, Tvh and Jitter, Shimmer, NHR of Group 2.Conclusion In clinical practice, the VAA can be used to evaluate the severity of voice disorders and VHI can reflect the subjective feelings of teachers with voice disorders. Both of them can apply to the voice quality assessment.