罗晖晖 詹善强 向维仁 段飞 王星星

*基金项目：九江市重点研发计划指导性计划项目（S2021ZDYFN110）

【摘要】 目的：观察嗓音训练在声带息肉患者术后康复中的应用效果。方法：将2021年7月—2022年7月九江市第一人民医院80例行声带息肉切除术治疗的患者资料予以回顾性分析，并根据是否进行术后嗓音训练分成对照组（30例，术后给予常规噤声干预）与试验组（50例，在对照组基础上应用嗓音训练干预），观察患者声带恢复情况、嗓音质量、声学参数、复发率。结果：试验组总体声带恢复情况明显好于对照组，差异有统计学意义（P<0.05）；干预后，试验组嗓音障碍指数量表（VHI）各项评分、嗓音嘶哑分级量表（GRBAS）等级、振幅微扰（shimmer）、基频微扰（jitter）改善程度均明显优于对照组，差异均有统计学意义（P<0.05）；试验组10周训练后、一年半后声带息肉复发率均明显低于对照组，差异均有统计学意义（P<0.05）。结论：嗓音训练在声带息肉患者术后康复中可发挥较好的作用，可改善患者术后嗓音发声障碍与发声质量，实施后患者具有较低的术后复发风险。

【关键词】 嗓音训练 声带息肉 术后康复 嗓音障碍指数 嗓音嘶哑程度

Application of Voice Training in Postoperative Rehabilitation of Patients with Vocal Cord Polyps/LUO Huihui， ZHAN Shanqiang， XIANG Weiren， DUAN Fei， WANG Xingxing. //Medical Innovation of China， 2024， 21（15）： 0-067

[Abstract] Objective： To observe the application effect of voice training in postoperative rehabilitation of patients with vocal cord polyps. Method： The data of 80 patients who underwent vocal cord polypectomy in Jiujiang NO.1 People's Hospital from July 2021 to July 2022 were analyzed retrospectively. And according to whether postoperative voice training was performed， they were divided into a control group （30 cases， with routine voice ban intervention after surgery） and a test group （50 cases， with voice training intervention applied on the basis of the control group）. The recovery of vocal cords， voice quality， acoustic parameters and recurrence rate were observed. Result： The overall recovery of vocal cords in the test group was significantly better than that in the control group， with statistically significant difference （P<0.05）. After intervention， the improvement of voice handicap index （VHI） scores， classification of grade， roughness， breathiness， asthenia， strain （GRBAS）， shimmer and jitter in the test group were significantly better than those in the control group， the differences were statistically significant （P<0.05）. The recurrence rates of vocal cord polyps in the test group after 10 weeks of training and one and a half years later were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Voice training plays an effective role in postoperative rehabilitation of patients with vocal cord polyps. It can improve postoperative voice handicap and voice quality， and lower the risk of postoperative recurrence.

[Key words] Voice training Vocal cord polyps Postoperative rehabilitation Voice handicap index Degree of voice hoarseness

First-author's address： Otolaryngology Head and Neck Surgery， Jiujiang NO.1 People's Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2024.15.015

声带是位于喉部的一组肌肉组织，主要负责声音的产生和调节。频繁的声带使用，如大声说话、唱歌或者长时间的演讲会导致声带过度疲劳，或喉咙感染、喉咙干燥或者长期接触刺激性物质（如烟草、化学物质等）使声带组织发炎，嗓音过度紧张、声带张力或者呼吸技巧不正确等导致声带过度震动及遗传性声带结构异常等因素，均会增加声带组织损伤和息肉形成的风险[1]。声带息肉是一种常见的喉部疾病，通常生长在声带的黏膜表面，可以单侧或双侧出现，呈乳白色或粉红色，通常呈圆形或椭圆形，较小的点状增生到较大的肉芽肿均可出现。声带息肉会影响声带的正常振动，导致声带功能受限，进而影响患者正常的发声和说话，造成声带的不适或疼痛[2]。声带息肉常通过雾化治疗配合手术切除，但手术后声带可能会出现肿胀、疼痛和声音质量下降的问题，复发风险较高。……