功能性发声障碍患者嗓音及心理状态评估分析

目的 通过对功能性发声障碍患者进行嗓音和心理状态评估,探讨其在功能性发声障碍诊疗中的临床意义。 方法 选取72例功能性发声障碍患者(实验组)和无嗓音障碍的正常人(对照组)40例。其中功能性发声障碍组中功能增强型发声障碍 50 例,功能减弱型发声障碍22例。所有患者均进行计算机嗓音评估、GRBAS评估、嗓音障碍指数量表(VHI)、动态喉镜检查、焦虑自评量表(SAS)及抑郁自评量表(SDS)评估,对比两组之间各项指标评估结果。 结果 实验组GRBAS评分为(1.92±1.03)分,VHI自评分为(58.43±23.17)分,频闪喉镜检查实验组声带闭合、黏膜波、对称性及周期性评分与对照组差异均有统计学意义;计算机嗓音评估中,实验组频率微扰、振幅微扰及最长声时与对照组差异有统计学意义;SAS评分及SDS评分实验组与对照组差异有统计学意义。 结论 完善的嗓音和心理状态评估对功能性发声障碍患者的诊治具有重要的指导意义。

Evaluation of voice and mental state in patients with functional dysphonia

Objective We aimed to explore the clinical importance of voice and mental state assessment in the diagnosis and treatment of functional speech disorders. Methods We selected 72 patients with functional dysphonia(experimental group)and 40 individuals without dysphonia(control group)from the Department of Otolaryngology, Affiliated Hospital of Qingdao University, from August 2017 to October 2020. In the functional dysphonia group, 50 individuals had enhanced dysphonia and 22 had diminished dysphonia. All patients underwent voice assessment, evaluation using the Grade, Roughness, Breathiness, Asthenia, Strain(GRBAS)scale and voice handicap index(VHI)scale, dynamic laryngoscopy, and evaluation of anxiety(Self-Rating Anxiety Scale, SAS)and depression(Self-Rating Depression Scale, SDS). We compared evaluation results of the various indicators between the two groups. Results In the experimental group, the GRBAS score was 1.92±1.03 and the VHI score was 58.43±23.17. Vocal cord closure, mucosal wave, symmetry, and periodicity scores in the experimental group were significantly different from those of the control group, in stroboscopic examination. In computer voice evaluation, the frequency perturbation, amplitude perturbation, and maximum sound time in the experimental group were significantly different from these values of the control group. We found significant differences in SAS and SDS scores between the experimental and control groups. Conclusion Voice and mental state assessment are important for guiding the diagnosis and treatment of patients with functional phonation disorder.