非综合征型听神经病患者前庭上下成分功能障碍定位研究与频率特征

目的 探讨听神经病伴发前庭功能障碍的可能性,并分析其部位和频率特征。 方法 以眼肌前庭诱发肌源性电位(oVEMP)、颈肌前庭诱发肌源性电位(cVEMP)、视频头脉冲试验(vHIT)、头脉冲抑制试验(SHIMP)和冷热试验对20例(40耳)非综合征型听神经病患者进行前庭功能评估,对统计学处理结果进行客观分析。 结果 20例患者(40耳)接受oVEMP和cVEMP测试,oVEMP异常率为85%,cVEMP异常率为95%,差异无统计学意义。11例(22耳)接受vHIT和SHIMP测试,外、上、后半规管vHIT和SHIMP的异常率分别为14%、18%、9%和9%,组间差异无统计学意义。19例患者行冷热试验,异常率为74%。11例接受vHIT和SHIMP测试的患者,冷热试验异常率为82%,显著高于vHIT和SHIMP异常率,差异有统计学意义。 结论 听神经病患者存在前庭功能障碍,前庭上下成分(包括感受器和前庭上下神经)受累概率相当,耳石器和半规管均可受累,各半规管受累概率相当,半规管功能损伤主要累及低频。     

前庭性眩晕疾病患者焦虑和抑郁状况研究

目的 研究临床上常见的四种前庭性眩晕患者的焦虑/抑郁状况及其眩晕残障程度等相关因素并进行分析,为临床诊治四种前庭性眩晕提供依据。 方法 搜集确诊为前庭性眩晕的患者,分别为良性阵发性位置性眩晕(BPPV)、前庭性偏头痛(VM)、梅尼埃病(MD)及前庭神经炎(VN)四种疾病,记录患者的病程、持续时间等一般资料,完善耳科学检查并进行医院焦虑抑郁量表(HAD)、眩晕残障量表(DHI)测定。 结果 纳入前庭性眩晕患者121例,其中BPPV47例,VM31例,MD29例,VN14例,四组患者焦虑/抑郁阳性率分别为BPPV 31.9%、VM 71.0%、MD 75.9%、VN 42.9%;轻度、中度及重度眩晕残障程度分别为BPPV 58.9%、19.8%、21.3%,VM 19.4%、25.8%、54.8%,MD 6.9%、24.1%、69.0%,VN 38.6%、21.4%、40.0%。焦虑与抑郁评分之间线性相关(r=0.570,P<0.05);DHI与HAD评分之间线性相关(r=0.804;P<0.05)。 结论 前庭性眩晕患者存在不同程度的焦虑/抑郁,且焦虑和抑郁有一定的相关性;VM和MD患者焦虑/抑郁的发生率较高;VM、MD及VN患者眩晕残障程度高于BPPV患者。因此在临床上诊治前庭性眩晕疾病的时候要重视患者的焦虑/抑郁状态,特别是VM、MD患者,以便更好的治疗前庭性眩晕。     

不同伴发症状的良性复发性眩晕患者前庭功能特点分析

目的初步了解不同伴发症状的良性复发性眩晕患者的临床表现及前庭功能检查特点。方法回顾分析解放军总医院眩晕诊疗中心收治的91例复发性眩晕患者,按照伴发症状分为四组,偏头痛组(A组);非偏头痛的头痛组(B组);畏光和/或畏声组(C组),无头痛、无畏光-畏声组(D组)。观察四组患者的临床表现及发前庭功能特点结果 1)四组性别比例及前庭症状、诱发因素无明显差异2)偏头痛组恶心呕吐率较高为78.6%(c2=11.274,P=0.001)3)四组均有不同程度的耳鸣,畏光畏声组及无头痛无畏光畏声组有较高的耳鸣患病率50%。4)四组前庭诱发肌源电位的潜伏期延长率及振幅异常率均显著高于UW异常率及平滑跟踪异常率。5)偏头痛组及畏光畏声组2项以上前庭功能检查受损率较高。结论1)有偏头痛病史及发作时伴有畏光畏声的良性复发性眩晕患者自主神经反应更明显,前庭功能受损更严重。2)良性复发性眩晕患者尽管无明显听力受损但是会伴有有不同程度的耳鸣3)良性复发性眩晕患者不管伴发症状如何VEMP异常率均高于其他前庭功能检查。     

儿童突发性聋的临床特征及预后相关因素分析

目的 分析儿童突发性聋的临床特征、疗效及影响预后的相关因素,为临床治疗及预后评估提供依据。 方法 收集2010年1月至2017年10月就诊的67例突发性聋患儿临床资料,对其临床特征及治疗效果进行回顾性分析,同时根据疗效将患者分为总体有效组(36例)及无效组(31例),采用单因素及多因素分析的方法分析患者的性别、年龄、病程、初诊听阈、是否伴发耳鸣、眩晕、病毒感染史、发病季节和听力曲线类型对预后的影响。 结果 儿童突聋患者中64.18%在春冬季发病,其就诊时听阈为(76.62±25.97)dB HL,耳鸣及眩晕伴发率分别为70.15%和61.19%,病毒感染率为19.40%,听力曲线中10.44%为低频下降型、2.99%为高频下降型、34.33%为平坦型及52.24%为全聋型。经治疗后,患者听阈为(60.41±31.52)dB HL,总体有效率为53.73%,其中痊愈率、显效率及有效率分别为20.90%、16.42%和16.42%。多因素分析结果显示,初诊听阈越高及听力曲线为全聋型,预后越差(P均<0.05);伴有病毒感染的非全聋型患者预后较好(P<0.05)。 结论 儿童突发性聋患者病毒感染率较高且大部分在春冬季发病,就诊时听力损失较重并常伴有耳鸣及眩晕,其听力曲线以平坦型及全聋型为主。就诊时听力损伤程度轻、伴有病毒感染的非全聋型患者预后较好。     

后半规管良性阵发性位置性眩晕急性发作时的临床表现

目的 观察和总结后半规管良性阵发性位置性眩晕(PSC-BPPV)急性发作时的临床特征,为临床诊断提供依据。 方法 回顾性分析115例PSC-BPPV患者急性发作时的临床表现,分析并总结患者的性别和年龄分布、发病时状态、头晕性质、眩晕发作与头部活动间的关系、眼震、伴随症状、辅助检查等临床特征。 结果 PSC-BPPV急性发作时的临床表现具有以下特征:(1)女性多于男性;(2)易累及50岁以上人群;(3)在起床、躺卧、翻身或活动中头部主动或被动到某一位置时突然发病,特别是晨起发病居多;(4)剧烈的眩晕伴有恶心、呕吐;(5)部分患者在初次查体时表现出旋转性眼震;(6)不伴有耳蜗和神经系统症状和体征;(7)颅脑影像学检查无阳性相关发现。 结论 急诊时如患者在起床、躺下、翻身或头部活动到某一位置时突然出现剧烈的眩晕发作,不伴有耳蜗和神经系统症状体征,颅脑影像学检查无相关阳性发现,应当考虑PSC-BPPV的诊断,及早行Dix-Hallpke诱发试验能够确立诊断。     

主观视觉垂直线和水平线检查软件的研发与应用

目的 自主研发主观视觉垂直线(SVV)、主观视觉水平线(SVH)检查软件。主要用于判断双侧耳石器功能的对称性和优势偏向侧,评估耳石器功能的静态代偿状态,指导前庭康复。 方法 研发SVV/SVH检查软件,结合消除视觉参考的桶状设备及暗环境检查室,收集80例健康志愿者检查数据,确定正常参考值范围。研究方法为横断面研究。 结果 80例健康志愿者,SVV检查平均值偏离度范围为:-3.00°~3.00°,其平均值的均值(±标准差)为:-0.29(±1.42)°;SVH检查平均值偏离度范围为:-4.00°~3.50°,其平均值的均值(±标准差)为:-0.38(±1.84)°。 结论 自主研发的SVV/SVH软件95%正常值参考范围分别为:-3.13°~2.55°,-4.06°~3.30°;此检查软件和设备可以用于前庭耳石器机能状态的评估,与其他前庭检查设备如前庭诱发肌源性检查、双温试验、甩头试验等相结合,全面评估患者的前庭功能和前庭代偿状态,指导前庭康复。     

头晕眩晕与眼震强度的关系研究

目的 通过冷热试验诱发头晕和/或眩晕时的眼震强度,探讨头晕眩晕与眼震强度的关系。 方法 对399例前庭周围性疾病患者进行常规冷热试验检查,以双耳冷热气刺激诱发出头晕和/或眩晕感时的眼震强度为指标,比较分析头晕及眩晕感与眼震强度的关系。 结果 冷热刺激诱发头晕眩晕及关联眼震总体分析,出现眩晕时的眼震强度总是大于头晕。左右耳冷热气刺激诱发头晕、眩晕的眼震阈值分别为:左耳冷4.2°/s、5.9°/s,左耳热4.2°/s、8°/s,右耳冷4.6°/s、6.2°/s,右耳热5.3°/s、 6.5°/s。399例患者进行双耳冷热交替刺激,共计1 596次试验,诱发出头晕513次(32.14%),其中312次仅有头晕、201次在头晕后10 s左右还出现眩晕;诱发出眩晕906次(56.77%),其中705次直接出现眩晕,无从头晕向眩晕进行过渡,另201次眩晕出现在头晕10 s左右之后;未引出头晕眩晕378次(23.68%)。 结论 眩晕对应的眼震强度阈高于头晕,眼震较弱时患者表现为头晕,较强时则呈现眩晕。冷热气刺激诱发眼震强度由弱到强及同时存在的由头晕到眩晕现象,提示头晕眩晕症状与两侧前庭张力差的大小相关。     

气导声刺激前庭诱发肌源性电位在正常儿童中的表现

目的 探讨研究正常儿童中气导声刺激诱发的眼性前庭诱发肌源性电位(oVEMP)和颈性前庭肌源性诱发电位(cVEMP)的各项参数指标,并对正常值进行统计学处理分析。 方法 选择4~10岁听力正常健康儿童52例,以500 Hz短纯音作为刺激音,分别行 oVEMP和cVEMP检测,记录左、右耳引出率及波形参数,并采用SPSS统计软件进行统计学处理分析。 结果 双耳皆未引出oVEMP 2例,单耳可引出oVEMP4例,oVEMP总体引出率为92%。双耳皆未引出cVEMP 2例,cVEMP总体引出率为96%。oVEMP与cVEMP的P1潜伏期分别为(17.07±0.89)ms、(15.55±1.58)ms;N1潜伏期分别为(12.39±0.91)ms、(23.10±2.29)ms;N1P1间期分别为(4.68±0.88)ms、(7.83±1.56)ms;oVEMP与cVEMP的振幅分别为(7.24±4.79)μV、(197.40±118.37)μV。双耳间oVEMP及cVEMP振幅不对称比分别为(19.03±12.50)%、(22.16±18.64)%。患儿左右耳的潜伏期,P1N1间期及振幅差异无统计学意义(P>0.05)。 结论 绝大部分正常儿童经气导声刺激可引出oVEMP与cVEMP。该检测患儿依从性高,可用来评估儿童前庭功能。此研究结果可为我国的儿童气导VEMP提供正常参考值范围。     

高压氧疗治疗大前庭导水管综合征患儿急性听力丧失九例

目的 目的探讨高压氧疗治疗大前庭导水管综合征患儿急性听力丧失的临床效果。 方法 对急性听力丧失的大前庭导水管综合征患者9例11耳,进行为期2周共10次高压氧治疗。 结果 患儿均耐受良好,治疗后复查纯音听阈测试,提示患耳听阈均有明显改善。 结论 9例患儿对高压氧疗耐受良好,治疗效果显著,高压氧疗可以成为大前庭导水管综合征急性听力丧失患者的治疗方法之一。     

高刺激率ABR与儿童良性阵发性眩晕的相关性

目的探讨高刺激率听性脑干诱发电位(ABR)在诊断儿童良性阵发性眩晕(Benign ParoxysmalVertigo of children,BPV)的临床价值。方法根据BPV诊断标准,选取BPV的儿童60例和非BPV对照组20例。BPV组根据眩晕病程进展分为2周内眩晕发作组和无眩晕发作组。所有入组病例行听力学检查,对纯音测听听阈阈值、声导抗、高刺激率ABR进行比较,分析BPV及对照组之间听力学特征差异。结果(1)BPV组60例患儿及对照组20例儿童纯音测听、声导抗检查结果全部正常,听力无显著性差异。(2)BPV组中高刺激率ABR异常率为41.7%(25/60),正常对照组高刺激率ABR异常率为0%(0/20),两者有统计学差异,P<0.01。BPV组中:2周内眩晕发作组和无眩晕发作组,分别进行高刺激率ABR检查:2周内眩晕发作组高刺激率ABR异常率为63.6%(21/33),而2周内无眩晕发作者高刺激率ABR异常率为14.8%(4/27),两者有统计学差异,P<0.01。结论高刺激率ABR与儿童BPV、尤其是发作期的BPV具有一定的相关性。     

学龄前儿童眩晕的病因分析及诊断方法的合理选择

目的 探讨学龄前儿童眩晕的常见病因、临床表现特点及合理的诊断方法.方法 回顾性分析12例学龄前儿童眩晕的临床表现特点、诊疗经过、结果及家长对各项诊断方法的接受程度.结果 (1) 12例患儿的诊断结果为:分泌性中耳炎3/12,儿童良性发作性眩晕3/12,内耳畸形3/12,良性阵发性位置性眩晕2/12,梅尼埃病1/12.(...     

Brainstem lesion in benign paroxysmal vertigo children: Evaluated by a combined ocular and cervical vestibular-evoked myogenic potential test

Objective

This study utilized a combined ocular vestibular-evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) test in children with benign paroxysmal vertigo (BPV) to investigate whether the upper or lower brainstem is more frequently affected in BPV children.

Methods

Fifteen BPV children aged 4-14 years, and 15 age- and sex-matched healthy children were enrolled. All subjects underwent pure tone audiometry, stabilometry, and a combined oVEMP and cVEMP test using acoustic stimulation.

Results

All BPV patients displayed normal hearing and clear oVEMPs. However, 11 (73%) of 15 BPV patients had delayed cVEMPs, showing significant difference when compared with 100% normal cVEMPs in healthy children. The sway path and sway area in stabilometry were significantly different between BPV and healthy children, regardless of whether their eyes were open or closed. However, neither the sway path nor sway area correlated significantly with cVEMP results.

Conclusion

Normal oVEMPs in BPV children indicate an intact vestibulo-ocular reflex pathway, which travels through the upper brainstem. In contrast, delayed cVEMPs in BPV children reflect a retrolabyrinthine lesion along the sacculo-collic reflex pathway, which descends via the lower brainstem. Hence, the lower brainstem is more frequently affected than the upper brainstem in children with BPV.     

Neurootological aspects of juvenile vertigo

Pathologies from childhood to adolescence carry physical, cognitive, motor, linguistic, perceptual, social, emotional, and neurosensory characteristics. The ages between 8 and 14 or 15 especially carry very special traits of a rollover in data processing with respect to balance regulation. Data acquisition of neurootological function provides us with a network of information about the sensory status of our young patients. Major neurootological complaints leading to functional neurootological investigations are vertigo (including giddiness), dizziness, and nausea. These complaints may occur acutely but also are present in some patients at a young age as longer-lasting complaints. Physiological and clinical vertigo syndromes are commonly found as a combination of four principal phenomena: perceptual (vertigo), oculomotor (nystagmus), postural (dystaxia), and vegetative (nausea, vomiting). These four cardinal manifestations of vertigo are related to different levels of the vestibular analyzer and require different methods of investigation. The focus of our study is the phase of restructuring of equilibrium regulation in children between the ages of 8 and 15 years.     

Therapeutic efficacy of the Epley canalith repositioning maneuver

OBJECTIVES/HYPOTHESES: The hypotheses of the current study are as follows: 1) That if the Epley canalith repositioning maneuver is an effective treatment for benign positional vertigo (BPV), relief from the vertigo should occur virtually immediately after the performance of the maneuver; 2) that the Epley canalith repositioning maneuver does provide almost immediate relief in BPV and should be the established treatment of choice for this disorder in both primary and tertiary care settings; and 3) that residual symptoms of lightheadedness and imbalance do persist after the resolution of the vertigo. The distinction of these symptoms from the vertigo is required for the accurate evaluation of the efficacy of positional maneuvers. STUDY DESIGN: Prospective cohort study in a tertiary care balance center. METHODS: Eighty-six patients (95 cases) with a history and physical examination consistent with active BPV were entered in the study. Patients were treated with a modified Epley canalith repositioning maneuver. A modified 360 degrees roll was used to treat those patients with horizontal canal BPV. Patients were provided with a preprinted diary in which they were to circle the answer most relevant to their symptoms for 14 days after the maneuver. Patients were then re-evaluated in the office at 2 weeks after the maneuver. RESULTS: The mean duration of the BPV before treatment was 9 weeks. Seventy-four percent of cases that were treated with one or two canalith repositioning maneuvers had a resolution of vertigo as a direct result of the maneuver. A resolution attributable to the first intervention was obtained in 70% of cases within 48 hours of the maneuver. An additional 14% of cases that were treated had a resolution of vertigo; however, it is not possible to say that these patients definitely benefited from the canalith repositioning maneuver. Only 4% of cases (three patients) manifested BPV that persisted after four treatments. Residual symptoms of lightheadedness or imbalance, or both, were frequent (47% of cases) but rarely required formal intervention with vestibular rehabilitation physical therapy. CONCLUSIONS: The Epley canalith repositioning maneuver results in a resolution of vertigo in the majority of patients (70% of cases) immediately after one treatment. It is safe and requires no special equipment or investigations. It should be established as the treatment of choice for BPV in both primary and tertiary care settings.     

影响低频下降型突发性聋不伴眩晕预后的相关因素分析

目的 分析相关因素对低频下降型突发性聋不伴眩晕预后的影响。 方法 共搜集符合纳入标准的低频下降型突发性聋106例的临床资料,分析性别、年龄、侧别、病程、伴随症状、听力损失程度与治疗效果之间的相关性。 结果 低频下降型突发性聋的总有效率79%,年龄≤30岁者治疗的总有效率最高(91%,31/34),高于31~45岁组(80%,37/46)和46~68岁组(61%,16/26),差异有统计学意义(P<0.05);病程≤7 d者(95%,52/55)预后要好于病程>7 d者(63%,32/51),差异有统计学意义(P<0.001);伴有耳闷者治疗效果(88%,53/60)优于不伴有耳闷者(37%,31/46),差异有统计学意义(P<0.05)。性别、发病侧别、是否伴有耳鸣、听力损失为轻度或中度,各组之间总有效率差异无统计学意义(P>0.05)。 结论 不伴眩晕的低频下降型突发性聋的预后与年龄、病程、是否耳闷及初始听力水平有关,与性别、侧别、是否伴耳鸣无关;年龄小、病程短、伴耳闷是不伴眩晕的低频下降型突发性聋预后良好的正性因素。     

儿童与成人人工耳蜗植入术并发症比较及处理

目的 探讨儿童与成人人工耳蜗植入术并发症的不同特点,总结其处理经验。方法 回顾性分析170例人工耳蜗植入患者的病历资料,根据年龄将其分为儿童组及成人组,分析比较两组人工耳蜗植入术并发症出现的特点及处理经验。结果 170例人工耳蜗电极均一期植入,成功率100%。术后3 d内出现发热患者15例,儿童13例(8.84%),成人2例(8.69%),发热率差异无统计学意义(P>0.05)。内耳发育正常的患者术后出现眩晕21例,儿童10例(10.20%),成人11例(52.38%),儿童术后眩晕率较成人低(P<0.05)。1例成人患者人工耳蜗植入出现术后头皮血肿,予头皮血肿抽吸后痊愈。1例儿童患者人工耳蜗植入术后外耳道口皮肤穿孔,经手术修复痊愈。1例儿童患者人工耳蜗植入术后18个月皮下植入体损坏,行再次人工耳蜗植入术。结论 人工耳蜗植入术后不同并发症的发生在不同年龄阶段表现不一,对人工耳蜗植入术后并发症与年龄的趋向性进行比较分析,为临床工作者对其预见及处理提供相关经验及依据。     

Caloric and vestibular evoked myogenic potential tests in evaluating children with benign paroxysmal vertigo

OBJECTIVE: This study applied caloric and vestibular evoked myogenic potential (VEMP) tests to evaluate whether children with benign paroxysmal vertigo (BPV) shares similar vestibular features with basilar type migraine. METHODS: Twenty subjects of each group including healthy and BPV children were enrolled in this study. Each subject underwent audiometry, caloric and VEMP tests. Diagnosis of BPV was based on the International Classification of Headache Disorder, second edition. RESULTS: All BPV children had normal hearing, bilaterally. Caloric test revealed normal responses in 13 patients and abnormal responses in 7 patients (35%). VEMP test showed 50% abnormality in BPV children, including absent and delayed responses. However, when results of caloric and VEMP testing were considered together, 70% of BPV children had abnormality, exhibiting non-significant difference compared with 75% abnormality in basilar type migraine. CONCLUSIONS: A combination of caloric and VEMP results reveals higher abnormality (70%) in BPV children, sharing similar features with basilar type migraine in adults, given the similarity of the two disorders. Thus, caloric and VEMP tests may serve as supplementary diagnostic tools in evaluating children with BPV.     

儿童分化型甲状腺癌的临床特征及危险因素分析

目的 近年来,儿童甲状腺癌发病率不断上升,因此探讨儿童分化型甲状腺癌(children differentiated thyroid cancer,DTC)的临床特征并分析复发病例情况。 方法 回顾性分析1998年1月~2018年5月在上海交通大学医学院附属新华医院就诊的年龄≤13岁的50例儿童分化型甲状腺癌的临床资料。以7岁为界分为学龄前期组(≤7周岁)和学龄期组(>7周岁至13周岁),比较学龄前期与学龄期的临床特征情况。根据儿童DTC复发与否进行分组,比较复发组与无复发组的临床特征数据。比较临床特征、TNM分期及AJCC推荐的风险水平、复发及转移情况。采用Kaplan-Meier评价各年龄组无复发生存率。 结果 50例中,学龄前期与学龄期在局部侵犯情况有显著统计学差异(P=0.008),学龄前期组的局部侵犯比例(6例,42.6%)高于学龄期组(3例,8.1%)。两组肿瘤T分期存在明显差异(χ2=12.584,P=0.028),学龄期组T2比例较高(19例,51.4%),而学龄前期组T4a比例较高(5例,38.5%)。手术并发症比例,学龄前期组显著多与学龄期儿童(χ2=9.632,P=0.008)。无发复组双侧甲状腺全切比例明显高于复发组(85.7%,53.3%)(χ2=11.227,P=0.004),甲状腺全切可以降低儿童DTC复发风险。复发组与无复发组TNM与风险水平无统计学差异。复发组T1a、T1b和T2的总百分比超过50%,低风险水平为37.5%,中风险水平25%。约半数的复发病例在最初诊断时是TNM分期较低的且为低风险水平的。儿童DTC术后复发率差异无统计学意义(P>0.05)。 结论 学龄前期DTC病例的局部浸润,肿瘤分期以及手术并发症比例高于学龄期,年龄是儿童DTC的重要危险因素。将近一半的复发病例在最初诊断时是低风险的,因此应进一步研究儿童DTC复发风险评估策略。应提高对儿童DTC病例临床特征了解并采取适当的治疗策略。     

Population-based study of vestibular symptoms in migraineurs

Conclusion: The differences between migraineurs with vertigo or motion sickness or both, and migraineurs with neither might reflect differences in migraine pathophysiology. Objective: To assess vestibular symptoms in 871 definite migraineurs. Methods: Data were gathered using a structured questionnaire. We considered responses to only 2/150 questions: (1) ‘have you had vertigo with or apart from your headaches?’ and (2) ‘have you experienced motion sickness most of your life?’. The target groups were: (a) migraineurs with either vertigo or motion sickness, ‘migraine with vestibular symptoms’ (MwVS), their control group being migraineurs with neither vertigo nor motion sickness, ‘migraine without vestibular symptoms’ (MwoVS); (b) migraineurs who reported vertigo, ‘migraine with vertigo’ (MwV); their control group being migraineurs without vertigo (MwoV). Results: Among the 871 definite migraineurs, 534 had MwV, 337 had MwoV, 663 had MwVS, and 208 had MwoVS. The MwVS group had more headache, aura, nausea, vomiting, osmophobia, allergy, allodynia, headache increasing with head motion, noise as trigger for headache, days needing analgesics, and higher migraine disability scores than the MwoVS group. The pattern was the same in the MwV vertigo group as in the MwVS group, apart from migraine disability scores, which were no different.     

4—8岁儿童嗓音声学参数结果分析

目的 掌握正常学龄前及学龄期儿童的嗓音数据,为病理嗓音提供参考标准。方法 用Dr.speech嗓音分析软件采集4－6岁（学龄前）及7－8岁（学龄期）各120例儿童的嗓音资料,并对取得的数据进行统计分析。结果 测出学龄前期及学龄期儿童嗓音的基频微扰、振幅微扰、信噪比、谐噪比、噪声能量、平均基频及第一至第三共振峰,在性别及年龄段之间均无明显差异。结论 正常学龄前儿童和学龄儿童间所有参数均无差异。正常儿童与声带小结等喉疾患儿间各项参数有非常显著差异。