舌系帶過短術后構音障礙患者的發(fā)音特點及矯治方法的研究
發(fā)布時間：2018-07-21 14:07
【摘要】：目的分析舌系帶過短術后構音障礙患者的發(fā)音特點,并制定出科學有效的矯治方法,為臨床中開展該類患者的評估及矯治提供依據(jù)。方法收集2015年7月~2017年1月以舌系帶延長術后、說話不清為主訴,就診于鄭州大學第一附屬醫(yī)院口腔語音治療科的患者,年齡均為四歲以上共176例。其中包括131例男孩,45例女孩,男女例數(shù)之比為2.91:1,年齡在4~29歲,平均(7.93±5.30)歲,使用美國KAY公司產的Model 4500型計算機語音工作站(Computer Speech Lab,CSL)按漢語語音清晰度測試表對176例患者錄音進行異常語音的檢測與評估,分析術后構音障礙患者的發(fā)音特點。對符合要求的4~8歲且智力聽力均正常的70例患者借助CSL按照語音清晰度字表分別在語音矯治前后錄音,并對錄音材料進行判聽分析以評價矯治效果。采用SPSS17.0進行統(tǒng)計處理,該研究屬于自身配對設計,對患者經語音矯治前后的效果進行配對t檢驗,檢驗水準α=0.05。結果1.176例患者中,錯誤方式多以置換和脫落為主,側化次之,扭曲少見。2.從發(fā)音位置觀察,術后患者構音錯誤發(fā)生百分比高低依次為:舌尖后音(93.8%)、舌尖前音(82.4%)、舌根音(68.2%)、舌尖中音(63.6%)、舌面音(61.4%)、唇齒音(27.3%)及雙唇音(22.7%)。3./b/、/d/、/t/、/q/、/x/、/z/、/c/與/i/組合時均置換成舌面音/j/;舌面音、舌尖前音及舌尖后音與/i/組合時出現(xiàn)側化構音,且發(fā)與/i/組合的詞語時,置換高于脫落;舌尖中音/l/的構音錯誤百分比高于舌根音;發(fā)音時送氣音/p/、/t/、/q/非送氣化為/b/、/d/、/j/。4.患者發(fā)21個輔音與/a/、/o/、/e/組合時構音錯誤百分比相對偏低且錯誤形式簡單,但與/i/、/u/、/ü/組合時不僅錯誤百分比高且形式較復雜。5.發(fā)/m/、/d/、/n/、/l/、/g/、/h/、/s/、/r/與/u/組合及發(fā)/n/、/l/、/j/、/q/與/ü/組合的字詞時輔音均脫落,/g/、/z/、/s/、/zh/與/u/組合時置換成/d/,/k/、/c/、/ch/與/u/組合時置換成/t/,舌面音則表現(xiàn)為同一發(fā)音部位的相互置換。6.通過1~3個療程的矯治,70例患者的語音清晰度均比矯治前有所提高,由語音矯治前的41.34,提高了42.03,達到語音矯治后的83.00,語音矯治前后差異有統(tǒng)計學意義(t=-29.254,P㩳0.001)。結論舌系帶延長術后構音障礙患者發(fā)音異常的臨床特點以置換和脫落為主,側化次之。應根據(jù)患者的發(fā)音特點,制定科學有效的矯治方法。本研究探討的語音矯治方法效果肯定,能顯著提高患者的語音清晰度。
[Abstract]:Objective to analyze the phonetic characteristics of dysarthria after short tongue band operation, and to establish a scientific and effective method for the evaluation and treatment of dysarthria in clinical practice. Methods from July 2015 to January 2017, 176 patients, aged more than 4 years, who were treated with oral phonetics therapy department of the first affiliated Hospital of Zhengzhou University, were treated with tongue band lengthening operation and inarticulate speech as the main complaint. These included 131 boys and 45 girls, with a ratio of 2.91 to 1: 1, with an average age of (7.93 鹵5.30) years. According to the Chinese speech articulation test table, the abnormal speech of 176 patients with dysarthria was detected and evaluated by Model 4500 computer speech Workstation made by Kay Company in USA, and the pronunciation characteristics of patients with dysarthria after operation were analyzed. Seventy patients with normal intelligence and hearing were recorded before and after speech correction according to the speech articulation word table by CSL, and the recording materials were analyzed to evaluate the effect of correction. SPSS 17.0 was used for statistical processing. The study was a self-paired design. The effect of speech correction was tested by paired t test, and the test level was 偽 0.05. Results in 1.176 patients, replacement and shedding were the main ways of error, followed by lateralization, distortion was rare. 2. 2. From the position of articulation, the percentage of missounds occurred in patients after operation were as follows: posterior tone of tongue tip (93.8%), anterior tone of tip of tongue (82.4%), root tone of tongue (68.2%), middle tone of tip of tongue (63.6%), tone of face of tongue (61.4%), tone of lip teeth (27.3%) and double lip sound (22.7%). When the front of the tongue and the back of the tongue are combined with /, the displacement is higher than that of the loss; the percentage of errors in the construction of the middle of the tongue / is higher than that in the root of the tongue; and the air exhalation at the time of articulation is greater than that of the root of the tongue. The percentage of errors in 21 consonants and / or / or combinations is relatively low and the form of errors is relatively simple, but it is not only a high percentage of errors but also a more complicated form when combined with / r / I / r / r. The consonants of the / respectively, the words of / the words / The speech intelligibility of 70 patients treated with 1 ~ 3 courses of treatment was improved as compared with that before treatment. From 41.34 to 42.03, it reached 83.00 after speech correction. There was significant difference between before and after speech correction (t -29.254 P0. 001). Conclusion the main clinical features of dysarthria after tongue extension are replacement and abscission, followed by lateralization. Scientific and effective methods of correction should be formulated according to the pronunciation characteristics of the patients. The method of speech correction discussed in this study is effective and can significantly improve the speech articulation of patients.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R782
[Abstract]:Objective to analyze the phonetic characteristics of dysarthria after short tongue band operation, and to establish a scientific and effective method for the evaluation and treatment of dysarthria in clinical practice. Methods from July 2015 to January 2017, 176 patients, aged more than 4 years, who were treated with oral phonetics therapy department of the first affiliated Hospital of Zhengzhou University, were treated with tongue band lengthening operation and inarticulate speech as the main complaint. These included 131 boys and 45 girls, with a ratio of 2.91 to 1: 1, with an average age of (7.93 鹵5.30) years. According to the Chinese speech articulation test table, the abnormal speech of 176 patients with dysarthria was detected and evaluated by Model 4500 computer speech Workstation made by Kay Company in USA, and the pronunciation characteristics of patients with dysarthria after operation were analyzed. Seventy patients with normal intelligence and hearing were recorded before and after speech correction according to the speech articulation word table by CSL, and the recording materials were analyzed to evaluate the effect of correction. SPSS 17.0 was used for statistical processing. The study was a self-paired design. The effect of speech correction was tested by paired t test, and the test level was 偽 0.05. Results in 1.176 patients, replacement and shedding were the main ways of error, followed by lateralization, distortion was rare. 2. 2. From the position of articulation, the percentage of missounds occurred in patients after operation were as follows: posterior tone of tongue tip (93.8%), anterior tone of tip of tongue (82.4%), root tone of tongue (68.2%), middle tone of tip of tongue (63.6%), tone of face of tongue (61.4%), tone of lip teeth (27.3%) and double lip sound (22.7%). When the front of the tongue and the back of the tongue are combined with /, the displacement is higher than that of the loss; the percentage of errors in the construction of the middle of the tongue / is higher than that in the root of the tongue; and the air exhalation at the time of articulation is greater than that of the root of the tongue. The percentage of errors in 21 consonants and / or / or combinations is relatively low and the form of errors is relatively simple, but it is not only a high percentage of errors but also a more complicated form when combined with / r / I / r / r. The consonants of the / respectively, the words of / the words / The speech intelligibility of 70 patients treated with 1 ~ 3 courses of treatment was improved as compared with that before treatment. From 41.34 to 42.03, it reached 83.00 after speech correction. There was significant difference between before and after speech correction (t -29.254 P0. 001). Conclusion the main clinical features of dysarthria after tongue extension are replacement and abscission, followed by lateralization. Scientific and effective methods of correction should be formulated according to the pronunciation characteristics of the patients. The method of speech correction discussed in this study is effective and can significantly improve the speech articulation of patients.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R782
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