早期声带息肉患者发声训练与嗓音显微手术的疗效比较

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。 

Efficacy comparison of vocal training and vocal microsurgery in patients with early vocal cord polyp

Objective To compare the efficacies of vocal training (VT) and vocal microsurgery (VM) in patients with early vocal cord polyp (EVCP). Methods Total 38 EVCP patients in the VT group underwent 3-month vocal training,and the dynamic laryngoscope,voice handicap index (VHI),and dysphonia severity index (DSI) were applied to assess the efficacy;31 EVCP patients in the VM group received the vocal microsurgery.The efficacies of VT and VM were compared,with P<0.05 considered as statistically significant. Results The cure rates of VT and VM group were 31.6% and 100%,respectively.Mann-Whitney U-test showed that the cure rate in VM group exceeded VT Group (Z=-5.792,P<0.001).The intragroup paired-sample t-test showed that the post-treatment VHI,MPT,Jitter,F₀-High,I-Low and DSI in both groups were improved than those before the treatment.The intergroup independent-sample t-test revealed that the E value,MPT,Jitter,and DSI in VT group were improved better as compared with VM group. Conclusion Both VT and VM,with their respective advantages,can improve the vocal quality in the patients with early vocal cord polyps.