發(fā)布時(shí)間：2018-03-05 19:57

  本文選題：成年女性　切入點(diǎn)：喉鏡檢查　出處：《南京醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察正常成年女性不同年齡生理時(shí)期喉部形態(tài)結(jié)構(gòu)特點(diǎn)及嗓音變化特征,探討喉鏡檢查及嗓音主客觀評(píng)估方法在成年女性嗓音評(píng)估中的應(yīng)用價(jià)值。方法:正常成年女性受試者分為三組,青年組:青年女性48例,年齡20～43歲;更年期組:更年期女性59例,年齡45～55歲;老年組:老年女性52例,年齡60～88歲。受試者首先采用電子鼻咽喉鏡檢查,然后進(jìn)行嗓音障礙視覺(jué)模擬量表(visual analog scale,VAS)評(píng)分、嗓音障礙指數(shù)(voice handicap index,VHI)量表簡(jiǎn)化中文版(VHI-13)評(píng)分、嗓音GRBAS主觀聽(tīng)感知評(píng)估和嗓音聲學(xué)檢測(cè)。觀察分析三組女性喉鏡下喉部形態(tài)及聲帶閉合的改變,比較更年期組與老年組的嗓音主觀評(píng)估結(jié)果,比較青年組、更年期組和老年組的嗓音聲學(xué)檢測(cè)結(jié)果,分析更年期組及老年組聲帶水腫及聲帶閉合不全與嗓音主客觀評(píng)估的關(guān)系。結(jié)果:更年期組受試者喉鏡檢查主要表現(xiàn)為聲帶水腫、喉黏膜干燥等,老年組受試者喉鏡檢查主要表現(xiàn)為聲帶閉合不全、聲帶萎縮等改變。更年期組大多數(shù)受試者及老年組所有受試者嗓音VAS、VHI、總嘶啞度(grade,G)和粗糙度(roughness,R)評(píng)分有所升高,老年組VAS和VHI評(píng)分高于更年期組(P0.05),老年組G、R重度異常的比例高于更年期組(P0.05)。嗓音聲學(xué)檢測(cè)顯示,與青年組比較,更年期組及老年組基頻微擾(jitter)、振幅微擾(shimmer)均升高,基頻(fundamental frequency,F0)、最長(zhǎng)發(fā)聲時(shí)間(maximum phonation time,MPT)和發(fā)音障礙指數(shù)(dysphonia severity index,DSI)則降低;老年組jitter、shimmer較更年期組更升高,而F0、MPT和DSI較之降低;更年期組及老年組聲帶水腫與聲帶無(wú)水腫受試者比較,G、R、jitter及shimmer值升高,F0及DSI值降低;聲帶閉合不全與聲帶完全閉合受試者比較,G、R、jitter及shimmer值升高,MPT及DSI值降低,以上差異均具有統(tǒng)計(jì)學(xué)意義(P0.05或0.01)。結(jié)論:更年期和老年期女性可出現(xiàn)喉部形態(tài)及聲帶結(jié)構(gòu)的改變(聲帶水腫、喉黏膜干燥、聲帶閉合不全、聲帶萎縮等),嗓音功能可出現(xiàn)衰退改變,表現(xiàn)嗓音主觀評(píng)估及聲學(xué)參數(shù)的異常。應(yīng)用嗓音主觀評(píng)估及聲學(xué)檢測(cè)方法結(jié)合電子鼻咽喉鏡檢查可對(duì)成年女性嗓音進(jìn)行綜合全面的評(píng)價(jià),為區(qū)別成年女性生理與病理性嗓音提供依據(jù)。
[Abstract]:Objective: to observe the morphological and structural characteristics of larynx and the change of voice in normal adult women at different ages. Methods: normal adult female subjects were divided into three groups: 48 young women aged 20 to 43 years old; The climacteric group consisted of 59 climacteric women aged 45 to 55 years old and 52 elderly women aged 6088 years. The subjects were examined by electronic nasopharyngeal laryngoscope, and then visual analog scale scale (VAS) was used to evaluate the voice disorders. Voice handicap index (VHI) scale simplified VHI-13) score, voice GRBAS subjective auditory perception evaluation and voice acoustic measurement. The changes of laryngeal morphology and vocal cord closure under laryngoscope in three groups were observed and analyzed. To compare the results of subjective evaluation of voice between menopausal group and senile group, and compare the results of voice acoustic test of young group, menopausal group and elderly group. To analyze the relationship between vocal cord edema and vocal cord insufficiency and subjective and objective evaluation of voice in climacteric group and senile group. Results: the laryngoscopy of climacteric group showed mainly vocal cord edema and dry laryngeal mucosa. The laryngoscopy of the elderly subjects mainly showed the changes of vocal cord closure and vocal cord atrophy. The scores of VAS-VHI, total hoarseness and roughness were increased in most subjects in climacteric group and all the subjects in the elderly group. The scores of VAS and VHI in the elderly group were higher than those in the climacteric group (P0.05), and the proportion of severe abnormal GGR in the elderly group was higher than that in the climacteric group. The fundamental frequency (F0), maximum phonation time (MPT) and dysphonia severity (DSI) were decreased, and the jittershimmer in the elderly group was higher than that in the climacteric group, while the F0 MPT and DSI were lower in the elderly group than in the climacteric group. Compared with non-edematous subjects, the scores of GG rjitter and shimmer increased and F0 and DSI decreased in climacteric group and aged group, and the values of GG rjitter and shimmer increased and DSI and DSI decreased in patients with incomplete vocal cord closure and complete vocal cord closure. Conclusion: the changes of laryngeal morphology and vocal cord structure (vocal cord edema, dry laryngeal mucosa, incomplete vocal cord closure) may occur in menopausal and elderly women. The vocal cord shrinks and so on, the voice function may appear the decline change, The subjective evaluation of voice and the abnormality of acoustic parameters can be used to evaluate the voice of adult women comprehensively by using the method of voice subjective evaluation and acoustic examination combined with electronic nasopharyngeal laryngoscopy. To provide the basis for distinguishing physiological and pathological voice of adult female.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R767

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 虞鵬程;孫廣濱;;喉肌電圖在各疾病中的臨床應(yīng)用進(jìn)展[J];中國(guó)醫(yī)學(xué)文摘(耳鼻咽喉科學(xué));2017年02期

2 付丹;劉加林;李孟嬌;楊翰;;痙攣性發(fā)聲障礙嗓音評(píng)估方法的系統(tǒng)評(píng)價(jià)[J];臨床耳鼻咽喉頭頸外科雜志;2016年15期

3 劉健慧;馬麗晶;張平;王軍;;顯微縫合技術(shù)治療聲帶任克水腫患者的嗓音評(píng)估[J];臨床耳鼻咽喉頭頸外科雜志;2014年03期

4 張武寧;吳鋮林;李永湘;鐘暉;毛海燕;;發(fā)音障礙嚴(yán)重指數(shù)在25例聲帶息肉患者中的應(yīng)用[J];中國(guó)眼耳鼻喉科雜志;2014年01期

5 胡環(huán)宇;徐潔潔;陳曦;吳虹;張舒;劉美暢;;老年人喉鏡觀察及嗓音聲學(xué)和空氣動(dòng)力學(xué)分析[J];江蘇醫(yī)藥;2013年14期

6 蔣家琪;舒敏;張毅;徐晨媚;;嗓音疾病的行為學(xué)治療——言語(yǔ)訓(xùn)練[J];中國(guó)眼耳鼻喉科雜志;2012年01期

7 李紅艷;徐文;胡蓉;張麗;韓德民;;嗓音障礙指數(shù)量表簡(jiǎn)化中文版的研究[J];聽(tīng)力學(xué)及言語(yǔ)疾病雜志;2010年06期

8 王飛;肖永濤;黃昭明;;藥物結(jié)合發(fā)聲訓(xùn)練治療功能性發(fā)音障礙的臨床研究[J];現(xiàn)代實(shí)用醫(yī)學(xué);2010年08期

9 劉韻;馬清學(xué);李革臨;張道行;;纖維頻閃喉鏡圖像分析對(duì)聲帶黏膜波的評(píng)價(jià)[J];中國(guó)中西醫(yī)結(jié)合耳鼻咽喉科雜志;2010年04期

10 米悅;林鵬;杜建群;魯宏華;陳佳媚;畢靜;;聲帶息肉與聲帶小結(jié)患者發(fā)聲空氣動(dòng)力學(xué)研究[J];聽(tīng)力學(xué)及言語(yǔ)疾病雜志;2010年02期

相關(guān)碩士學(xué)位論文 前2條

1 毛f3楠;痙攣性發(fā)音障礙的診斷及治療進(jìn)展[D];河北醫(yī)科大學(xué);2008年

2 張明星;嗓音主、客觀評(píng)價(jià)指標(biāo)的研究[D];第二軍醫(yī)大學(xué);2007年

，

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