唇腭裂语音治疗效果及相关因素研究分析

doi:10.7518/gjkq.2025079

摘要/Abstract

摘要：

目的分析唇腭裂患者语音治疗的效果及其影响因素，以提高语音治疗效果。方法回顾性分析2015年1月至2021年8月在广西医科大学附属口腔医院完成唇腭裂语音治疗的107名患者的病例资料，采用二元Logistic回归模型分析治疗结果及治疗效果的影响因素。结果语音初始清晰度对治疗效果的影响有统计学意义（χ²=58.142，P<0.001），初始语音清晰度差的患者，达到治疗效果的概率是初始语音清晰度欠佳患者的0.010倍（比值比为0.010，95%置信区间为0.001~0.100）。完成治疗的治疗次数，显效组为（11.38±3.66）次，好转组为（6.45±2.92）次，治疗显效组高于好转组（t=6.684，P<0.001）。语音清晰度（t=18.224，P=0.000）、腭咽闭合程度（t=12.925，P=0.000）在语音治疗前后都有明显变化，差异有统计学意义。结论影响语音治疗效果的因素是语音初始清晰度，唇腭裂的语音治疗在改善语音清晰度和提高腭咽功能方面有明显作用，合理的治疗次数是治疗效果的前提保证。

关键词: 唇腭裂, 语音治疗, 语音初始清晰度, 影响因素

Abstract:

Objective To investigate and analyze the effectiveness and factors of speech therapy for cleft lip and pa-late and thus improve treatment outcomes. Methods A retrospective analysis was conducted on the case data of 107 patients who underwent speech therapy for cleft lip and palate at the Affiliated Stomatology Hospital of Guangxi Medical University from January 2015 to August 2021. A binary logistic regression model was used to analyze the treatment outcomes and influencing factors of treatment effectiveness. Results A statistically significant difference in treatment outcomes exists because of initial speech clarity (χ² =58.142, P<0.001). The results of influencing factors indicate that the treatment effect for those with poor initial speech clarity is 0.010 times that of those with less than satisfactory initial speech clarity (odds ratio: 0.010, 95% confidence interval: 0.001-0.100). The number of treatment sessions completed was 11.38±3.66 for the markedly effective group and 6.45±2.92 for the improved group, with the markedly effective group having a higher number of treatments (t=6.684, P<0.001). Both speech clarity (t=18.224, P=0.000) and velopharyngeal function (t=12.925, P=0.000) showed significant changes before and after speech therapy, with statistically significant differences. Conclusion The factors that affect the effectiveness of speech therapy include initial clarity of speech. Speech therapy for cleft lip and palate significantly improves speech clarity and enhances velopharyngeal function. Moreover, a reasonable number of treatment sessions is a prerequisite for ensuring treatment effectiveness.

Key words: cleft lip and palate, speech therapy, initial speech clarity, influencing factor

中图分类号:

R782.2

王晓萌,邝海,何灏逾,李鸿艺,林洁舲,李飞燕. 唇腭裂语音治疗效果及相关因素研究分析[J]. 国际口腔医学杂志, 2025, 52(5): 627-633.

Xiaomeng Wang,Hai Kuang,Haoyu He,Hongyi Li,Jieling Lin,Feiyan Li. Effectiveness of cleft lip and palate speech therapy and related factors[J]. Int J Stomatol, 2025, 52(5): 627-633.

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检测项目	总人数n/%	治疗效果n/%		χ²/t值	P值
检测项目	总人数n/%	显效（≥50）	好转（<50）	χ²/t值	P值
性别^a				2.500	0.114
男	61/57.01	47/77.05	14/22.95
女	46/42.99	29/63.04	17/36.96
就诊年龄/岁				4.933	0.085
≤6	48/44.86	35/72.92	13/27.08
6~18	41/38.32	32/78.05	9/21.95
>18	18/16.82	9/50.00	9/50.00
手术年龄/月				3.595	0.166
≤18	19/17.76	11/57.89	8/42.11
18~72	56/52.34	44/78.57	12/21.43
>72	32/29.91	21/65.63	11/34.38
距离/km				0.273	0.601
≤130	51/47.66	35/68.63	16/31.37
>130	56/52.34	41/73.21	15/26.79
城乡差异				3.249	0.071
城镇	51/47.66	32/62.75	19/37.25
农村	56/52.34	44/78.57	12/21.43
文化程度				2.307	0.316
小学及以下	24/22.43	17/70.83	7/29.17
初中	52/48.60	40/76.92	12/23.08
高中及以上	31/28.97	19/61.29	12/38.71
家庭年收入/万元				1.447	0.485
≤5	30/28.04	23/76.67	7/23.33
5~10	41/38.32	30/73.17	11/26.83
>10	36/33.64	23/63.89	13/36.11
初始语音清晰度				58.142	<0.001
欠佳	43/40.19	13/30.23	30/69.77
差	64/59.81	63/98.44	1/1.56
治疗前腭咽功能				0.580	0.446
较差	26/24.30	20/76.92	6/23.08
尚可	81/75.70	56/69.14	25/30.86
治疗次数^b	9.95±4.11	11.38±3.66	6.45±2.92	6.684	<0.001

自变量	β	Wald χ²值	OR（95% CI）	P值
手术年龄/月
≤18			1
18~72	-1.386	1.747	0.250（0.032~1.953）	0.186
>72	0.349	0.076	1.418（0.118~17.007）	0.783
初始语音清晰度
欠佳			1
差	-4.637	15.139	0.010（0.001~0.100）	<0.001
治疗前腭咽功能
较差			1
尚可	0.403	0.181	1.496（0.234~9.555）	0.670
治疗次数 R²	-0.228	2.816	0.796（0.611~1.039）	0.093 0.701

检测项目	治疗前	治疗后	t值	P值
语音清晰度/%	34.20±19.55	93.37±5.99	18.224	0.000
腭咽闭合程度	1.11±0.72	0.28±0.47	12.925	0.000