本文選題：嗓音障礙 + 聲學(xué)測試�。� 參考：《第二軍醫(yī)大學(xué)》2012年碩士論文

【摘要】：目的：以德語嗓音障礙RBH聽感知評估系統(tǒng)為參考,對RBH聽感知評估系統(tǒng)進(jìn)行中文版化研究,并初步制定RBH聽感知評估系統(tǒng)中文版的標(biāo)準(zhǔn)培訓(xùn)光碟,為嗓音障礙RBH主觀聽感知中文版化評估系統(tǒng)的臨床應(yīng)用奠定基礎(chǔ)。 方法：(1)研究對象：嗓音障礙組79例,正常嗓音組15例。(2)主觀聽感知評估：采用德國RBH主觀聽感知評估系統(tǒng)中的R,B,H主觀參數(shù)對受試者進(jìn)行主觀等級評分；每個(gè)評估參數(shù)分為4個(gè)等級：0代表正常,1代表輕度異常,2代表中度異常,代表重度異常。(3)嗓音客觀參數(shù)的測量：采用Davis2.5和Pratt軟件對受試者的客觀參數(shù)Jitter、Shimmer、HNR、MPT和DSI的相關(guān)數(shù)值進(jìn)行測量。(4)統(tǒng)計(jì)學(xué)分析：首先對R,B,H進(jìn)行信度檢驗(yàn),包括評委自身一致性和評委間一致性；再比較H每相鄰兩個(gè)等級之間客觀嗓音聲學(xué)參數(shù)的差異,進(jìn)行效度檢驗(yàn)；最后將R,B,H與DSI進(jìn)行一致性檢驗(yàn),篩選出DSI與H等級完全一致的樣本作為RBH評估系統(tǒng)中文版的標(biāo)準(zhǔn)培訓(xùn)材料。采用SPSS11.5統(tǒng)計(jì)軟件,一致性檢驗(yàn)時(shí)選用Kappa系數(shù),效度檢驗(yàn)使用Mann-Whitney Test檢驗(yàn)。 結(jié)果：(1)以RBH作為主觀聽感知參數(shù),評委自身一致性以Kappa系數(shù)值表示,其數(shù)值為0.428-0.601,說明5位評委前后兩次對RBH這個(gè)整體參數(shù)評估的一致性好；評委間一致性以組內(nèi)相關(guān)系表示,2次評估的組內(nèi)相關(guān)系數(shù)值分別為0.74-0.79,0.689-0.762,證明第1次評估時(shí)5位評委間的一致性和第2次評估時(shí)5位評委間的一致性均好。(2)主觀聽感知參數(shù)R,B,H與客觀參數(shù)Jitter、 Shimmer、HNR、MPT和DSI等之間的相關(guān)性分析結(jié)果顯示：①主觀聽感知參數(shù)R,B,H與Jitter、Shimmer、HNR、MPT及DSI之間均具有顯著的相關(guān)性,差異有統(tǒng)計(jì)學(xué)意義(P均0.01)；②R與Jitter和HNR的相關(guān)性最強(qiáng),相關(guān)系數(shù)分別為0.551、0.499、0.550；③B與MPT,H與DSI呈高度負(fù)相關(guān),相關(guān)系數(shù)分別達(dá)0.620和0.613。說明主觀評估的結(jié)果與客觀結(jié)果大體上一致。(3)主觀聽感知參數(shù)R,B,H的4個(gè)等級中每相鄰2個(gè)等級之間的Jitter、Shimmer、HNR、 MPT及DSI比較差異均有統(tǒng)計(jì)學(xué)意義(p均0.05),說明R,B,H的等級劃分是合理、正確的。(4)通過R,B,H與DSI之間的一致性分析,將H與DSI完全一致的42例嗓音樣本納入標(biāo)準(zhǔn)培訓(xùn)光碟中,男女組成在各等級中基本平均分布,疾病譜廣泛全面,可作為RBH聽感知評估系統(tǒng)中文版的標(biāo)準(zhǔn)培訓(xùn)光碟,也為嗓音障礙RBH主觀聽感知評估系統(tǒng)中文版標(biāo)準(zhǔn)化的建立提供藍(lán)本。 結(jié)論：(1)以RBH主觀聽感知評估系統(tǒng)中文版評估參數(shù)評估嗓音障礙患者,評委自身一致性以及評委間一致性均好。(2)主觀評估的R,B,H參數(shù)結(jié)果與客觀評估參數(shù)的結(jié)果大體上一致。(3)R,B,H的等級劃分是合理、正確的。(4)初步制定的RBH聽感知評估系統(tǒng)中文版的標(biāo)準(zhǔn)培訓(xùn)光碟比較合理、可行,為進(jìn)一步開展全國多中心研究及臨床應(yīng)用打下良好的基礎(chǔ)。
[Abstract]:Objective: to study the Chinese version of the RBH auditory perception evaluation system based on the RBH auditory perception evaluation system for German voice disorders, and to develop a Chinese version of the standard training disc for the RBH auditory perception assessment system. To lay a foundation for the clinical application of RBH subjective auditory perception evaluation system. Methods: (1) subjects: 79 patients in the voice disorder group and 15 in the normal voice group. (2) subjective auditory perception assessment: the subjective parameters of RNBHs in the RBH subjective auditory perception evaluation system in Germany were used to evaluate the subjective grade of the subjects. Each evaluation parameter was divided into 4 grades: 0: 0 for normal and 1 for mild abnormality and 2 for moderate abnormality. (3) Measurement of objective voice parameters: using Davis2.5 and Pratt software to measure the relative values of the objective parameters Jitteri ShimmerHNRGMPT and DSI. (4) Statistical analysis: first, the reliability of RGN BH was tested. Including the consistency of the judges themselves and the consistency between the judges; then compare the differences of the objective voice acoustic parameters between the two adjacent grades of H, and test the validity; finally, we test the consistency between RBHs and DSI. Samples of DSI and H grades are selected as standard training materials for the Chinese version of RBH evaluation system. Using SPSS 11.5 statistical software, Kappa coefficient and Mann-Whitney Test were used for consistency test and validity test respectively. Results: (1) using RBH as the subjective auditory perception parameter, the consistency of the judges was expressed as the Kappa coefficient, whose value was 0.428-0.601, which indicated that the evaluation of RBH was consistent twice before and after the 5-bit judges; The intra-group correlation coefficient values of the two evaluations were 0.74-0.79 / 0.689-0.762respectively, which proved that the consistency of the five judges in the first evaluation and the consistency among the five judges in the second evaluation were good. (2) subjective sense of hearing. The results of correlation analysis between the known parameter RG BHH and objective parameters Jitter, ShimmerHNRNRT and DSI showed that the subjective auditory perception parameter RGBH1 had significant correlation with JitterShimmerHNRMMPT and DSI. There was significant difference (P0.01) in the correlation between jitter and HNR. The correlation coefficient was 0.551U 0.4990.5053B and MPTH was negatively correlated with DSI, and the correlation coefficients were 0.620 and 0.613respectively. The results of subjective assessment are consistent with objective results generally. (3) there are significant differences in Jitter ShimmerHNR, MPT and DSI between each of the four grades of subjective auditory perception parameter RG BNH (p 0.05). (4) through the consistency analysis between RDSI and RDSI, 42 voice samples with the same H and DSI were included in the standard training disc. The composition of male and female was distributed equally in all levels, and the disease spectrum was extensive and comprehensive. It can be used as the standard training disc of RBH auditory perception evaluation system in Chinese, and it can also provide a blueprint for the standardization of the Chinese version of RBH subjective auditory perception evaluation system for voice disorders. Conclusion: (1) the evaluation parameters of RBH subjective auditory perception evaluation system were used to evaluate patients with voice disorders. The consistency of the judges themselves and the consistency among the judges are good. (2) the results of the subjective evaluation of RGB-H parameters are generally consistent with the results of the objective evaluation parameters. (3) the classification of the RGB-H parameters is reasonable. (4) the Chinese version of RBH auditory perception evaluation system is reasonable and feasible, which lays a good foundation for further multi-center research and clinical application.
【學(xué)位授予單位】：第二軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R767.92

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