CPAP在边缘性腭咽闭合功能障碍患者言语治疗中的应用效果评价(1)
[摘要]目的：觀察正压通气治疗(Continuous positive airway pressure，CPAP)在边缘性腭咽闭合功能障碍(Marginal velopharyngeal dysfunction，MVPD)患者言语治疗中的应用效果，探讨腭咽闭合功能障碍诊治的相关机制。方法：对2017年1月-2019年1月于西安交通大学口腔医院颅颌面整形创伤外科言语语言治疗室就诊的MVPD患者行前瞻性前后自身对照研究，通过CPAP辅助的言语语言治疗。评估患者治疗前后鼻音变化程度;对比使用CPAP前后，构音治疗目标音诱发难度;治疗前后代偿性发音改善情况。采用SPSS 26.0软件包对数据进行分析。结果：47例MVPD患者，除1例治疗中断外，余46例患者均完成言语语言治疗。在言语语言治疗中使用CPAP辅助治疗，治疗周期平均为10.37次，治疗前后鼻音变化具有统计学意义(t=10.45，P<0.05)，通过CPAP辅助，言语治疗时目标音的诱发测试难度减低，差异具有统计学意义(t=21.74，P<0.05)，代偿性发音消失或改善，差异具有统计学意义(t=4.98 ，P<0.05)。结论：CPAP在MVPD患者构音障碍治疗中可以发挥积极作用，具有良好的临床运用效果。腭咽协调异常是MVPD患者的重要腭咽机制，也是CPAP发挥作用的原因之一。
[关键词]腭裂;正压通气治疗;边缘性腭咽闭合功能障碍;言语治疗;高鼻音;代偿性发音
[中图分类号]R782.2+2 [文献标志码]A [文章编号]1008-6455(2020)09-0049-04
The Effectiveness of CPAP in Speech Therapy for Cleft Palate Patients with Marginal Vealopharyngeal Dysfunction
YANG Yan-yan， MA Si-wei， REN Zhan-ping，YANG Bin-ting
(Department of Craniofacial Plastic Surgery，Xi’an Jiaotong University Stomatological Hospital，Xi’an 710004，Shaanxi，China)
Abstract：Objective To observe the effect of continuous positive airway pressure (CPAP) on speech therapy in patients with marginal velopharyngeal dysfunction(MVPD).To explore the mechanisms of velopharyngeal dysfunction. Methods This is a prospective controlled study involving patients at the Cleft Lip and Palate Center of Stomatological Hospital of Xi'an Jiaotong University between January 2017 to January 2019.The CPAP was used to assist speech therapy.The level of hypernasality， the difficulty of stimulability of the target sound and the compensatory articulation was analyzed pre- and post-speech therapy. The data were analyzed using the SPSS 26.0. Results A total of 47 MVPD patients were included in the study， except one whose therapy was interrupted. The mean therapy period was 10.37 times. Paired T test identified that the level of hypernasality(t=10.45，P<0.05) and the difficulty of stimulability of the target sound(t=21.74，P<0.05) and the compensatory articulation(t=4.98，P<0.05) were difference in receptive pre- and post- speech therapy. Conclusion CPAP could play an effective role in the treatment of articulation disorders in MVPD patients. Abnormal palatopharyngeal coordination is an important mechanism in patients with MVPD and is one of the reasons why CPAP works.
Key words： cleft palate; continuous positive airway pressure; marginal velopharyngeal dysfunction; speech therapy; hypernasality; compensatory articulation, 百拇医药(杨艳艳 马思维 任战平 杨彬婷)
[关键词]腭裂;正压通气治疗;边缘性腭咽闭合功能障碍;言语治疗;高鼻音;代偿性发音
[中图分类号]R782.2+2 [文献标志码]A [文章编号]1008-6455(2020)09-0049-04
The Effectiveness of CPAP in Speech Therapy for Cleft Palate Patients with Marginal Vealopharyngeal Dysfunction
YANG Yan-yan， MA Si-wei， REN Zhan-ping，YANG Bin-ting
(Department of Craniofacial Plastic Surgery，Xi’an Jiaotong University Stomatological Hospital，Xi’an 710004，Shaanxi，China)
Abstract：Objective To observe the effect of continuous positive airway pressure (CPAP) on speech therapy in patients with marginal velopharyngeal dysfunction(MVPD).To explore the mechanisms of velopharyngeal dysfunction. Methods This is a prospective controlled study involving patients at the Cleft Lip and Palate Center of Stomatological Hospital of Xi'an Jiaotong University between January 2017 to January 2019.The CPAP was used to assist speech therapy.The level of hypernasality， the difficulty of stimulability of the target sound and the compensatory articulation was analyzed pre- and post-speech therapy. The data were analyzed using the SPSS 26.0. Results A total of 47 MVPD patients were included in the study， except one whose therapy was interrupted. The mean therapy period was 10.37 times. Paired T test identified that the level of hypernasality(t=10.45，P<0.05) and the difficulty of stimulability of the target sound(t=21.74，P<0.05) and the compensatory articulation(t=4.98，P<0.05) were difference in receptive pre- and post- speech therapy. Conclusion CPAP could play an effective role in the treatment of articulation disorders in MVPD patients. Abnormal palatopharyngeal coordination is an important mechanism in patients with MVPD and is one of the reasons why CPAP works.
Key words： cleft palate; continuous positive airway pressure; marginal velopharyngeal dysfunction; speech therapy; hypernasality; compensatory articulation, 百拇医药(杨艳艳 马思维 任战平 杨彬婷)