改良兰氏+反向双Z法腭裂手术对患儿发音影响的临床研究(1)
[摘要]目的：探讨改良兰氏+反向双Z法腭裂手术对患儿发音的影响。方法：选取2013年2月-2016年1月行改良兰氏法+软腭双层“Z”形三角瓣修复法的30例腭裂患儿为观察组，选取既往予以兰氏两瓣法进行治疗的30例腭裂患儿为对照组。比较两组患儿手术前后腭咽闭合不全率、元音[i]的第二共振峰(F2)、第三共振峰(F3)、F1振幅能量值(A1)、辅音样本冲直条、擦音乱纹出现率以及语音清晰度。结果：两组患儿术后腭咽闭合不全率均低于术前(P<0.05)；观察组患儿术后腭咽闭合不全率低于对照组(P<0.05)。与手术前相比，两组患儿术后F2、F3高于术前，A1低于术前，差异有统计学意义(P<0.05)；观察组患儿术后F2、F3高于对照组，A1低于对照组(P<0.05)。观察组患儿术后辅音样本冲直条、擦音乱纹出现率高于对照组，差异有统计学意义(P<0.05)。两组患儿术后语音清晰度均高于手术前(P<0.05)；观察组患儿术后语音清晰度优于对照组，差异有统计学意义(P<0.05)。结论：腭裂手术软腭延长能有效改善腭裂患儿腭咽闭合功能，改善发音。
, http://www.100md.com [关键词]改良兰氏；反向双Z法；腭裂；儿童；发音
[中图分类号]R782.2+2 [文献标志码]A [文章编号]1008-6455(2018)07-0116-04
Abstract： Objective To investigate the effect of modified Lanzi plus reverse double Z on cleft palate in children. Methods From February 2013 to January 2016， 30 cases of children with modified cleft palate and soft palate double Z shaped triangular flap repair method of cleft palate as observation group， select the previous two patients were treated by Rana's method. Two groups were compared before and after surgery of velopharyngeal incompetence rate，[i]second vowel formants，third formant amplitude， F1 energy， rushed straight， fricative consonant sample random lines appear rate and speech intelligibility. Results The rate of velopharyngeal insufficiency in two groups was lower than that before operation (P<0.05)，and the rate of velopharyngeal insufficiency in the observation group was lower than that in the control group (P<0.05). Compared with pre operation， the postoperative F2 and F3 in the two groups were higher than before the operation and A1 was lower than that before the operation (P<0.05)， and the postoperative F2 and F3 in the observation group were higher than those in the control group， and the A1 was lower than the control group (P<0.05). The incidence rate of consonant samples in the observation group was higher than that in the control group (P<0.05). The speech intelligibility of the two groups was higher than that before operation (P<0.05)， and the speech intelligibility of the observation group was better than that of the control group (P<0.05). Conclusion Soft palate lengthening of cleft palate can effectively improve velopharyngeal function and improve pronunciation in patients with cleft palate.
, 百拇医药
Key words： modified langerhans； reverse double Z method； cleft palate； children； pronunciation
腭裂患者發音时鼻腔形成一个额外共鸣腔，进而对所发出的元音及浊辅音的音质产生影响，使之鼻音化[1]。在腭裂患者发辅音时，因气流可通过缝隙从口腔及鼻腔中逸出，导致口腔压力不足，为发出清晰语音，患者不自觉地用舌、唇、下颌、腭、咽等相关发音器官去阻塞腭裂裂隙，进而改善发音状况[2-3]。因此，如何尽可能恢复患者发音，成为临床研究热点之一。腭裂的治疗，目的在于重建腭部形态及良好的腭咽闭合，恢复期生理功能，可分为手术治疗及非手术治疗两大类，但临床上多采用腭裂修补术关闭腭咽，以改善患者的语音功能，提高患者生活质量[4-5]。研究发现，在腭裂手术中延长软腭，可更大程度地改善患者腭咽闭合功能。因此，本文就腭裂手术软腭延长对患儿的发音影响进行探讨，以期为腭裂患儿的治疗提供临床依据，现将结果报道如下。, http://www.100md.com(张新风 王鹏来 蒋常委)
, http://www.100md.com [关键词]改良兰氏；反向双Z法；腭裂；儿童；发音
[中图分类号]R782.2+2 [文献标志码]A [文章编号]1008-6455(2018)07-0116-04
Abstract： Objective To investigate the effect of modified Lanzi plus reverse double Z on cleft palate in children. Methods From February 2013 to January 2016， 30 cases of children with modified cleft palate and soft palate double Z shaped triangular flap repair method of cleft palate as observation group， select the previous two patients were treated by Rana's method. Two groups were compared before and after surgery of velopharyngeal incompetence rate，[i]second vowel formants，third formant amplitude， F1 energy， rushed straight， fricative consonant sample random lines appear rate and speech intelligibility. Results The rate of velopharyngeal insufficiency in two groups was lower than that before operation (P<0.05)，and the rate of velopharyngeal insufficiency in the observation group was lower than that in the control group (P<0.05). Compared with pre operation， the postoperative F2 and F3 in the two groups were higher than before the operation and A1 was lower than that before the operation (P<0.05)， and the postoperative F2 and F3 in the observation group were higher than those in the control group， and the A1 was lower than the control group (P<0.05). The incidence rate of consonant samples in the observation group was higher than that in the control group (P<0.05). The speech intelligibility of the two groups was higher than that before operation (P<0.05)， and the speech intelligibility of the observation group was better than that of the control group (P<0.05). Conclusion Soft palate lengthening of cleft palate can effectively improve velopharyngeal function and improve pronunciation in patients with cleft palate.
, 百拇医药
Key words： modified langerhans； reverse double Z method； cleft palate； children； pronunciation
腭裂患者發音时鼻腔形成一个额外共鸣腔，进而对所发出的元音及浊辅音的音质产生影响，使之鼻音化[1]。在腭裂患者发辅音时，因气流可通过缝隙从口腔及鼻腔中逸出，导致口腔压力不足，为发出清晰语音，患者不自觉地用舌、唇、下颌、腭、咽等相关发音器官去阻塞腭裂裂隙，进而改善发音状况[2-3]。因此，如何尽可能恢复患者发音，成为临床研究热点之一。腭裂的治疗，目的在于重建腭部形态及良好的腭咽闭合，恢复期生理功能，可分为手术治疗及非手术治疗两大类，但临床上多采用腭裂修补术关闭腭咽，以改善患者的语音功能，提高患者生活质量[4-5]。研究发现，在腭裂手术中延长软腭，可更大程度地改善患者腭咽闭合功能。因此，本文就腭裂手术软腭延长对患儿的发音影响进行探讨，以期为腭裂患儿的治疗提供临床依据，现将结果报道如下。, http://www.100md.com(张新风 王鹏来 蒋常委)
参见：首页 > 医疗版 > 疾病专题 > 口腔科 > 唇裂与腭裂 > 腭裂