喉癌患者喉部分切除术后的嗓音声学分析

目的 探讨喉癌患者喉部分切除术术式、喉功能重建方法与术后嗓音质量的关系。方法 采用Dr．Speech嗓音分析软件，对116例不同术式喉部分切除术患者分别于术后1、2年进行发声功能测试，对测得的基频微扰（jitter）、振幅微扰（shimmer）、标准化噪声能量（NNE）进行比较分析，判断受试者嗓音质量。结果 所测得的声学参数jitter、shimmer、NNE值，以喉声门上水平部分切除术组最低，嗓音质量相对最好（P〈0．01）；喉次全切除术组最高，嗓音质量相对最差（P〈0．01）。声带切除术组和声带癌激光切除术组与其它各组比较，其差异均有显著统计学意义（P〈0．05或0．01），但这两组间比较，差异无统计学意义。各组术后嗓音质量效果从好到差依次为：喉声门上水平部分切除术组、声带切除术组、声带癌激光切除术组、喉垂直部分切除术组、喉额侧部分切除术组、喉次全切除术组。结论 喉癌患者喉部分切除术后，发声功能的恢复与手术方式及重建方法密切相关，其中，喉声门上水平部分切除术组术后嗓音质量相对最佳，喉次全切除术组术后相对最差。

An Acoustic Analysis of Voice of Laryngeal Carcinoma Patients with Partial Laryngectomy

Objective To study the outcomes of voice restoration quality of patients partial laryngectomy.Methods 116 cases of patients received an examination of their voicing in 1year and 2 year after partial laryngectomy. The results were compared with normal voice and pathological voice data bank.Results The voice quality for the patients with supraglottic horizontal laryngectomy was the highest while for those with frontolateral partial laryngectomy was the poorest. Statistical analysis indicated significant differences among supraglottic horizontal laryngectomy, frontolateral partial laryngectomy and other partial laryngectomy(P<0.01). Statistical analysis indicated significant differences among the group of laryngofissure cordectomy, laser cordectomy and other partial laryngectomy(P<0.05 or 0.01). There was no significant difference between laryngofissure cordectomy and laser cordectomy. The voice quality from the best to worst was ranked for patients with supraglottic horizontal laryngectomy, laryngofissure cordectomy, laser cordectomy, frontolateral partial laryngectomy, vertical partial laryngectomy, and frontolateral subtotal laryngectomy.Conclusion Close relationships were noted among the method of surgery and voice quality after partial laryngectomy, and the supraglottic horizontal laryngectomy group had the best outcome while the frontolateral partial laryngectomy was the poorest.