【摘要】：腭裂患者由于鼻音功能亢進從而影響言語清晰度和溝通流暢。對鼻音功能亢進的腭裂兒童來講,有效準確地評估鼻音功能亢進,關(guān)系到腭裂患者能否及時得到有效地言語訓(xùn)練。鼻音功能亢進的評估分為主觀評估和客觀評估,其中主觀評估對評估者的要求很高,而客觀評估常以單一參數(shù)的評估為主,存在一定的局限性,因此簡單有效的多參數(shù)模型評估越來越受到國內(nèi)外學(xué)者的關(guān)注。本研究從聲學(xué)方面的客觀參數(shù)出發(fā),通過三個系列研究,建立和驗證了評估腭裂鼻音功能亢進的鑒別方程模型。研究一腭裂鼻音功能亢進敏感聲學(xué)參數(shù)的提取。(一)通過文獻初步篩選出與鼻音功能亢進有關(guān)的聲學(xué)參數(shù),包括呼吸、發(fā)聲、共鳴三個方面的參數(shù)。(二)通過比較3-14歲的30名腭裂鼻音功能亢進的兒童與30名普通兒童的上述聲學(xué)參數(shù),得到了10個有顯著差異的參數(shù)。(三)通過客觀參數(shù)敏感性的實驗,從10個有差異的參數(shù)中,最終提取了4個敏感性的聲學(xué)參數(shù),分別為最長聲時、i的0.5k-1k能量集中率、i的3k-4k能量集中率和鼻流量。最后通過客觀參數(shù)相關(guān)性的實驗,得到i的0.5k-1k能量集中率和i的3k-4k能量集中率呈高度相關(guān)。最終保留了3個敏感性的聲學(xué)參數(shù),分別為最長聲時、i的3k-4kHz能量集中率和鼻流量。研究二腭裂鼻音功能亢進鑒別方程模型的建立與驗證。模型建立采用的是鑒別分析的方法。通過65個被試建立了鑒別方程模型,模型為:Y0=-17.531+0.833XMPT+0.569Xi(3k-4k)+0.514XMNSY1=-19.880+0.006XMPT+0.595Xi(3k-4k)+0.768XMNSY2=-23.824+0.473XMPT+0.354Xi(3k-4k)+0.906XMNSY3=-21.854-0.216XMPT+0.409Xi(3k-4k)+0.923XMNS模型總體鑒別的準確性為73.8%。通過10個被試對模型進行驗證,得到鑒別方程模型的判別與主觀評估的一致性為70%。研究三腭裂鼻音功能亢進鑒別方程模型的臨床應(yīng)用。實驗選用一名4歲Ⅱ度腭裂兒童,運用鑒別方程模型分別對術(shù)前和術(shù)后進行鼻音功能亢進的評估,發(fā)現(xiàn)其與主觀評估結(jié)果的一致率為100%。進一步證明此模型的有效性。
[Abstract]:Cleft palate patients suffer from nasal hyperactivity, which affects speech clarity and communication fluency. For cleft palate children with nasal hyperfunction, effective and accurate evaluation of nasal hyperactivity is related to whether cleft palate patients can get effective speech training in time. The assessment of nasal hyperactivity can be divided into subjective assessment and objective assessment. Therefore, simple and effective multi-parameter model evaluation has attracted more and more attention from scholars at home and abroad. Based on the objective parameters of acoustics and three series of studies, a differential equation model for the evaluation of cleft palate nasal hyperactivity was established and verified. To study the extraction of sensitive acoustic parameters of a cleft palate with hyperfunction of nasal sound. (1) the acoustic parameters related to nasal hyperactivity, including breathing, phonation and resonance, were preliminarily screened by literature. (2) by comparing the above acoustic parameters between 30 children with cleft palate and 30 normal children aged 3-14 years, 10 parameters with significant difference were obtained. (3) through the experiment of sensitivity of objective parameters, four sensitive acoustic parameters were extracted from 10 different parameters, which were 3k-4k energy concentration rate and nose flow rate of 0.5k-1k energy concentration rate of the longest sound time. Finally, through the experiment of the correlation of objective parameters, it is found that I's 0.5k-1k energy concentration rate is highly correlated with I's 3k-4k energy concentration rate. Finally, three sensitive acoustic parameters were retained, which were the 3k-4kHz energy concentration rate and nose flow rate of the longest acoustic time. To study the establishment and verification of the differential equation model for nasal hyperactivity of second palate cleft palate. The method of discriminant analysis is used to establish the model. The discriminant equation model was established by 65 subjects, and the overall accuracy of the model was 73.8%. The model was -17.531 0.833XMPT 0.569Xi (3k-4k) 0.514XMNSY1=-19.880 0.006XMPT 0.595Xi (3k-4k) 0.768XMNSY2=-23.824 0.473XMPT 0.354Xi (3k-4k) 0.906XMNSY3=-21.854-0.216XMPT 0.409Xi (3k-4k) 0.923XMNS. The consistency between discriminant equation model and subjective evaluation is 70. To study the clinical application of the differential equation model of nasal hypertonia in patients with cleft palate. A 4-year-old second degree cleft palate child was used to evaluate nasal hyperfunction before and after operation by using differential equation model. The validity of the model is further proved.
【學(xué)位授予單位】：華東師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R782.22

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