耳外科手术患者全麻气管插管前后的嗓音声学分析

Acoustic analysis and comparison of voice before and after endotracheal intubation in patients undergoing ear surgery

摘要:

目的 探讨全麻气管插管对耳外科手术患者嗓音的影响。方法 对2017年1月-2017年10月河北医科大学第二医院耳鼻咽喉一科行耳外科手术治疗且均全麻下行气管插管术的成年患者52例插管前1 d、插管后第1天、插管后第3天进行嗓音声学分析，比较患者插管前后的基频（F₀）、基频微扰（Jitter）、绝对音调微扰（Jita）、振幅微扰（Shimmer）、扰动商（APQ）、噪谐比（NHR）等参数值变化。结果 与插管前1 d的Jitter和Jita相比，插管后第1天患者的Jitter和Jita呈现增加趋势，且均具有显著性差异（P<0.05）。但在插管后第3天参数值回降至术前水平。除F₀插管前后无明显变化。其他参数插管后第1天与插管前1 d相比，前者也具有上升趋势，但均无显著性差异（P>0.05），且在插管后第3天时回降至术前水平大小。结论 全麻下气管插管可以导致部分声学参数的一过性改变，但未引起正常音调的改变及声音嘶哑，对嗓音没有显著影响。

Abstract:

Objective To explore the effect of endotracheal intubation on the voice of patients undergoing ear surgery. Methods Fifty-two adult patients who underwent ear surgery under general anaesthesia with endotracheal intubation in our department from Jan 2017 to Oct 2017 were included. Voice acoustic analysis was performed one day before intubation, 1 and 3 days after intubation in all the patients. The changes in acoustic parameters including fundamental frequency (F₀), fundamental frequency perturbation (Jitter), absolute tone perturbation (Jita), amplitude perturbation (Shimmer), perturbation quotient (APQ) and noise-harmonic ratio (NHR) were measured and compared. Results Compared with the Jitter and Jita of one day before intubation, those on the first day after intubation showed increasing trends, with significant differences (both P<0.05). However, their values returned to the preoperative level on the third day after intubation. The change of F₀ before and after intubation was insignificant. The other parameters on the first day after intubation were higher than those before intubation with statistically insignificant differences (all P>0.05), and returned to the preoperative level on the third day after intubation. Conclusion Endotracheal intubation may cause transient changes in some acoustic parameters without normal tone changes and hoarseness, and therefore has no significant effect on voice of patients undergoing ear surgery.