嗓音障碍指数对声带囊肿患者术后嗓音的自我评估

优质护理在声带息肉患者术后嗓音康复中的应用及对喉发声能力自主评分的效果作者：李希曼来源：《中外医学研究》2019年第03期【摘要】目的：探讨优质护理在声带息肉患者术后嗓音康复中的应用及对喉发声能力自主评分的效果。

方法：选择200例笔者所在医院耳鼻喉科手术治疗的声带息肉患者为研究对象，随机分为试验组和对照组，每组100例，对对照组患者给予常规护理干预，对试验组患者在常规护理的基础上给予优质护理干预，比较两组的生活质量、治疗效果及自主发声能力。

结果：试验组患者生活质量各维度得分高于对照组，自主发声能力评分低于对照组，治疗效果优于对照组，差异均有统计学意义（P<0.05）。

结论：优质护理可以提高接受手术治疗的声带息肉患者的生活质量、治疗效果及自主发声能力，值得在临床上推广应用。

【关键词】优质护理; 声带息肉; 生活质量; 治疗效果doi：10.14033/ki.cfmr.2019.03.044 文献标识码 B 文章编号 1674-6805（2019）03-00-03声带息肉是耳鼻喉科收治的常见病种，是指声带固有层浅层的良性增生性病變，是慢性喉炎的特殊类型[1]。

近几年，患有声带息肉的人数逐年增多，让患者减少发声、声音训练、药物治疗、手术切除是治疗声带息肉的主要治疗措施[2]。

但是，喉镜切除后若患者用声过度、吸烟等可延缓患者嗓音的康复，降低喉发声的能力，恶化治疗效果。

对术后的患者进行护理干预可以落实医嘱的顺利实现，协助治疗，促进患者嗓音的康复。

优质护理措施是近几年临床上引入的新型护理理念，意在为患者提供全方位的护理照顾，从而促进患者康复[3]。

优质护理已广泛应用于临床实践，且取得了满意效果。

研究表明，优质护理可以改善治疗结局，提高护理满意度和生活质量。

研究发现，将优质护理应用于接受手术切除的声带息肉患者并探究其效果的研究并不多见，且以往文献多存在一定的局限性，例如样本量较少、研究设计缺乏严谨的随机对照试验、评估干预指标不全等[4]。

声带息肉患者手术前后VHI量表主观评估和 DSI 嗓音检测结果分析张武宁;唐安洲;徐志文;吴铖林;李永湘;钟晖;毛海燕【摘要】Objective To explore the significance of the Self -assessments of Voice Handicap Index (VHI) and The objective detection of Dysphonia Severity Index (DSI) in polyp of vocal cord perioperatively .Methods The Self -assessments of VHI had been completed in 28 patients with polyp of vocal cord before the operation and one week after theoperation ,including function(F) ,physiological(P) ,emotion(E) ,and the sum denoted by T .In the meantime ,The DSI had been completed in these patients by acoustic analysis of DIVAS 2 .5 .After one month ,19 pa-tients had been re -examined .Results The DSI value was increasing ,but there was no significant difference be-tween pre-operation and one week after the operation(P>0 .05) ,indicating that the function of vocal cord was not recovered .In VHI scale ,the parameters were significantly different between the time preoperatively and one week postoperatively in F ,E and T(P<0 .05) ,howevre ,it was not significantly different inP(P>0 .05) ,indicating that the function of vocal cord was not completely recovered as same as the result of DSI .After one month ,there were significant differences in DSI and VHI ,which showed a full recovery of vocal cord fanction .Conclusion The Self -assessments of VHI and The objective detection of DSI in polyp of vocal cord can evaluate simultaneouly the function of laryngeal .Additionally ,there was a goodcorrelation between the DSI and the VHI score .%目的探讨声带息肉患者手术前后嗓音障碍指数（voice handicap index ，VHI）量表自我评估和嗓音障碍严重指数（dysphonia severity index ，DSI）评估的价值。

声带息肉的显微手术治疗及嗓音评估赵丽娜张雷【摘要】［摘要］目的分析声带息肉显微声带缝合术后的嗓音改善情况。

方法对33例广基声带息肉患者行支撑喉镜手术，用8-0可吸收线对术中形成的较大黏膜缺损或残留正常黏膜瓣缝合并固定。

术前、术后2周、1月行总嘶哑度、粗糙度、气息度、听觉感知评估（GRABS）评分及客观嗓音分析。

结果术后2周与术前相比，无论是听觉感知评估还是客观各项声学参数检测均有明显改善，差异均有统计学意义（t分别=5.51、3.87、4.87、6.56、5.34、8.66，P均＜0.05）。

术后2周时声带稍充血，声带振动幅度及黏膜波轻度减轻。

术后1月声带形态恢复正常，且声带振动和黏膜波的传播恢复。

术后1月与术后2周相比，频率微扰和振幅微扰较前改善，差异均有统计学意义（t分别=2.97、4.54，P均＜0.05），余各项声学参数比较，差异均无统计学意义（t分别=1.73、1.46、1.01、1.62，P均＞0.05）。

结论支撑喉镜下显微缝合技术可促进声带息肉术后嗓音恢复，改善嗓音质量。

【期刊名称】全科医学临床与教育【年(卷),期】2015(000)004【总页数】4【关键词】［关键词］支撑喉镜；嗓音评估；显微缝合；声带［Abstract］ObjectiveTo evaluate the voice improvement after the suspend laryngoscope surgery combined with microsuture techniques in vocal fold polyps.MethodsThe epithelial defects and micro-flaps of all 33 vocal fold polyps patients who underwent resection of vocal foldpolyps through suspend laryngoscope under microscope were sutured and fixed with 8-0 absorbable suture.All the patients underwent evaluation of vocal function included the perceptual grade，roughness，breathness，aesthenia，GRBAS and objective voice analysis pre-operation and post-operation.ResultsTwo weeks after post-operative，the GRBAS and objective acoustic parameters were improved significantly compared with the pre-operative（t=5.51，3.87，4.87，6.56，5.34，8.66，P＜0.05）.The vocal cords were slightly congested，vibration amplitude and mucosa wave of the vocal cords mildly decreased at two weeks after post-operative.The vocal form kept well，vocal fold vibration amplitude and mucous wave returned to normal values at 1 months after post-operative，and jitter and shimmer were improved significantly（t=2.97，4.54，P＜0.05），but there was no significantly difference of the other acoustic parameters（t=1.73，1.46，1.01，1.62，P＞0.05）.ConclusionsThe suspend laryngoscope surgery combined with micro-suture techniques on vocal fold polyps can promote the recovery and improve voice quality.［Key words］suspend laryngoscope；voice assessment；microsuture；vocal fold近年来，声带显微缝合术被广泛应用于任克氏水肿等声带弥漫性病变的治疗，且其术后嗓音恢复确实有明显改善［1］，且得到大多数嗓音外科医生的一致认同。