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[嗓音障碍严重程度指数在喉反流相关嗓音疾病中的应用]

[Application of dysphonia severity index in laryngeal reflux related voice diseases].

作者信息

Zhang F, Yao L, Peng Y C, Zheng S X

机构信息

Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, 518036, China.

Department of Stomatology, Peking University Shenzhen Hospital.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov 20;31(22):1745-1748. doi: 10.13201/j.issn.1001-1781.2017.22.0010.

DOI:10.13201/j.issn.1001-1781.2017.22.0010
PMID:29798189
Abstract

To discuss the validity and reliability of dysphonia severity index in evaluating the effect of diagnosis and treatment of laryngeal reflux related voice diseases. 54 cases of voice disease patients accompanied by laryngopharyngeal reflux from January 2016 to June 2017 in department of otorhinolaryngology of our hospital were divided into two groups according to treatment type. 32 cases in the operation group received laser surgery and standard acid suppression therapy for 6 weeks, and 22 patients in the non-operation group received standard acid suppression therapy for 6 weeks. 24 h multichannel impedance pH (MCII-pH) monitoring was carried out. The indexes of reflux symptom, reflux finding score, subjective auditory perception and objective acoustic parameters of voice were measured before and after treatment, and the dysphonia severity index was calculated and analyzed. There was no significant difference in age, sex and course of disease between the two groups (> 0.05).Compared with pre-treatment, RSI, RFS, Jitter, Shimmer, G and R in two groups decreased significantly after treatment, and MPT, DSI increased significantly (<0.05). Before treatment, RSI, RFS, Jitter, Shimmer, G and R in the operation group were significantly higher than those in the non-operation group, and MPT, DSI were lower (<0.05). There were no significant differences in the parameters between the two groups after treatment (> 0.05). DSI was negatively correlated with GRBAS scoring parameters, Jitter and Shimmer, and positively correlated with RSI, RFS, and MPT (<0.01). DSI is related to the location of the lesion (<0.05) The incidence of anxiety was 27.27% in patients with moderate and severe sudden sensorineural hearing loss, and the incidence of depression was 25.25%. The scores of anxiety and depression were statistically significant (<0.05). The multivariate logistic regression analysis showed that the status of anxiety and depression was accompanied by symptoms and other diseases (<0.05). There was a significant difference between the effective group, the significant efficacy group and the cured group (<0.05). The difference between the scores before and after treatment was compared. Differences in the ineffective group compared with the other three groups, and the cured group compared with the other three groups of anxiety, depression were statistically significant. DSI can be used as an objective evaluation index for the diagnosis and treatment of laryngeal reflux related voice diseases, and it is accurate and reliable.

摘要

探讨嗓音障碍严重程度指数在评估喉反流相关嗓音疾病诊断及治疗效果中的有效性和可靠性。选取2016年1月至2017年6月我院耳鼻咽喉科收治的54例伴有喉咽反流的嗓音疾病患者,根据治疗方式分为两组。手术组32例接受激光手术及标准抑酸治疗6周,非手术组22例接受标准抑酸治疗6周。进行24小时多通道阻抗pH(MCII-pH)监测。治疗前后测量反流症状、反流发现评分、主观听觉感知及嗓音客观声学参数等指标,并计算分析嗓音障碍严重程度指数。两组患者年龄、性别及病程比较,差异无统计学意义(>0.05)。与治疗前比较,两组治疗后反流症状指数(RSI)、反流发现评分(RFS)、基频微扰(Jitter)、振幅微扰(Shimmer)、噪声谐波比(G)及粗糙度(R)均显著降低,最长发声时间(MPT)、嗓音障碍严重程度指数(DSI)显著升高(<0.05)。治疗前,手术组RSI、RFS、Jitter、Shimmer、G及R均显著高于非手术组,MPT、DSI低于非手术组(<0.05)。两组治疗后各参数比较,差异无统计学意义(>0.05)。DSI与GRBAS评分参数、Jitter及Shimmer呈负相关,与RSI、RFS及MPT呈正相关(<0.01)。DSI与病变部位有关(<0.05)。中度及重度突发性聋患者焦虑发生率为27.27%,抑郁发生率为25.25%,焦虑及抑郁评分差异有统计学意义(<0.05)。多因素logistic回归分析显示,焦虑及抑郁状态与伴随症状及其他疾病有关(<0.05)。有效组、显效组及治愈组间差异有统计学意义(<0.05)。比较治疗前后评分差异。无效组与其他三组比较,治愈组与其他三组比较焦虑、抑郁差异有统计学意义。DSI可作为喉反流相关嗓音疾病诊断及治疗的客观评估指标,准确可靠。

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