吹气训练在74例腭裂患者语音治疗中的效果评价

目的 评价吹气训练在腭裂患者语音治疗中的效果。方法 选择符合纳入标准的腭裂咽成形术后表现为腭咽闭合不全（VPI）代偿性语音患者74例,平均年龄10.98岁,采用吹气训练行为疗法与汉语语音训练相结合原则,在运用屏气时吹水泡、吹气球训练基础上,进一步诱导辅音擦音、塞音送气方式。采用SPSS 21.0软件包对数据进行统计学分析。结果 4~6岁组、7~12岁组和≥13岁组患者吹水泡平均时间由训练前的6.37、7.0和9.96 s分别提高到24.87、26.96和29.07 s,差异有统计学意义（P<0.001）。训练前各组患者均无法完成吹气球动作,训练后各组吹气球成功率分别达到88.9%（4~6岁组）、84.0%（7~12岁组）和90.9%（≥13岁组）。训练前各组患者擦音f和s、塞音p均为脱落或弱化,训练后达到正常语音清晰度,差异有统计学意义（P<0.001）。结论 屏气的吹气训练方法对增强腭咽闭合功能及塞音和擦音的送气诱导有显著效果。

Evaluation of the effect of blowing exercise on speech therapy in 74 patients with cleft palate

PURPOSE: To investigate the effect of blowing training behavior on speech therapy in patients with cleft palate. METHODS: Seventy-four patients with compensatory speech of velopharyngeal incompetence(VPI) who were treated with pharyngoplasty were recruited in this study, with an average age of 10.98 years old. According to the principle of combining blowing exercise behavior therapy with Chinese speech training, the consonant was further induced, and fricative and plosive were produced to send the air way on the basis of blowing blisters and blowing balloons while holding breath. SPSS 21.0 software package was used for data analysis. RESULTS: The blowing time was increased from 6.37, 7.0 and 9.96 seconds before blowing exercise to 24.87, 26.96 and 29.07 seconds after blowing exercise, respectively, in the three age groups 4-6 years old, 7-12 years and ≥13 years old; the difference was statistically significant (P<0.001). Before exercise, each group of patients could not complete balloon blowing, the success rate of balloon blowing in each group reached 88.9%(4-6 years old group), 84.0%(7-12 years old group) and 90.9%(≥13 years old group) later. Prior to the training of each group of patients, fricative f, s, plosive p were shedding or weakening, while all patients obtained normal pronunciation after exercising, the difference was statistically significant(P<0.001). CONCLUSIONS: Mastering the exercising method of breath when holding up the soft palate is effective in enhancing velopharyngeal closure and inducing pronouncing fricative and plosive.