Hiệu quả của bài tập tiếng việt cho bệnh nhân liệt dây thần kinh quặt ngược một bên sau cắt tuyến giáp toàn bộ

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Tác giả: Thị Mai Bùi, Minh Đạt Lê, Thị Mai Phương Mai, Anh Dũng Phạm, Thị Bích Đào Phạm, Thị Bích Thủy Phạm, Văn Tâm Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 617.51 *Head

Thông tin xuất bản: Tạp chí nghiên cứu y học, 2021

Mô tả vật lý: 146-153

Bộ sưu tập: Metadata

ID: 489351

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Tóm tắt
Chủ đề

The rate of total thyroidectomy due to thyroid cancer has been gradually increasing. Total thyroidectomy is usually accompanied by postoperative voice changes, especially when the recurrent laryngeal nerve (LRN) is damaged. Our study was confined to 60 patients with damaged LRN after total thyroidectomy at Hanoi Medical University Hospital, Vietnam National Otolaryngology Hospital, and Vietnam National Cancer Hospital from 1/2015 to 1/2020. Patients were divided into 2 groups(:) Group 1 of 30 patients received voice therapy and Group 2 of 30 patients were observed with no intervention. The voice quality of all the patients was evaluated after 03 months, 06 months, and 12 months by PRAAT. Results(:) Intervened group (Group 1)(:) movements of arytenoid cartilages and affected vocal cord were improved, no vocalis muscle atrophy was observed, and glottis closure was improved. After voice therapy, jitter index, shimmer index, noise-to-harmonic ratio (HNR), vowels (low, mid, high), consonants, tone, voice's fundamental frequency (F0, F1, F2), and the ability to prolong pronunciation of the intervened group were improved compared to the control group (p và lt
0.005). Conclusion(:) It is recommended to provide voice therapy for patients with LRN palsy after total thyroidectomy.Tỷ lệ phẫu thuật cắt tuyến giáp toàn bộ do ung thư tuyến giáp có xu hướng tăng dần, đi kèm với phẫu thuật này là những thay đổi về giọng sau phẫu thuật, đặc biệt là tổn thương dây thần kinh hồi quy sau phẫu thuật. Mục tiêu của nghiên cứu nhằm đánh giá hiệu quả của bài tập tiếng Việt trên những bệnh nhân liệt thần kinh thanh quản quặt ngược sau phẫu thuật cắt toàn bộ tuyến giáp. Nghiên cứu được tiến hành trên 60 bệnh nhân bị tổn thương dây thần kinh hồi quy sau phẫu thuật cắt toàn bộ tuyến giáp tại Bệnh viện Đại học Y Hà Nội, Bệnh viện Tai Mũi Họng Trung Ương, Bệnh viện K từ tháng 1/2015 đến tháng 1/2020. Đối tượng nghiên cứu được chia làm 2 nhóm(:) 30 người được can thiệp bằng bài tập và đánh giá chất lượng giọng của bài tập sau 03 tháng, 06 tháng và 12 tháng (nhóm 1) và 30 người khác theo dõi chất lượng giọng mà không có can thiệp gì thêm sau 03 tháng, 06 tháng và 12 tháng (nhóm 2). Chất lượng giọng được đánh giá bằng phần mềm phân tích âm PRAAT. Kết quả cho thấy ở nhóm 1(:) vận động của sụn phễu và dây thanh bên liệt cải thiện, không thấy hiện tượng teo cơ dây thanh, hai dây thanh khép kín hơn, các chỉ số(:) jitter, shimmer, noise-to-harmonic ratio (HNR) các nguyên âm (trầm, trung tính, cao), phụ âm, thanh điệu và tần số âm cơ bản (F0, F1, F2) đều cải thiện so với nhóm 2 (p và lt
0,005), khả năng kéo dài phát âm. Kết luận(:) Nhóm đối tượng liệt hồi quy sau cắt tuyến giáp toàn bộ nên được thực hiện bài tập phát âm.

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