Shaker训练和CTAR训练在鼻咽癌放疗后吞咽障碍中的应用对比

Comparison of Shaker Training and CTAR Training in the Treatment of Dysphagia after Radiotherapy for Nasopharyngeal Carcinoma

目的:探讨Shaker训练和CTAR训练在鼻咽癌放疗后吞咽障碍中的应用对比。方法:选取2017年1月-2018年6月到本院就诊的46例鼻咽癌放疗后吞咽障碍患者,按照治疗方法不同将患者分为对照组(15例)、Shaker组(15例)和CTAR组(16例)。对照组采用常规吞咽训练,Shaker组在对照组基础上采用Shaker训练,CTAR组在对照组基础上采用CTAR训练。观察三组患者VFSS评级、FOIS评分、SWAL-QOL评分、临床疗效以及不良反应发生情况。结果:治疗后2周,三组患者VFSS评级比较,差异均无统计学意义(P>0.05);治疗后4、6周,Shaker组和CTAR组患者VFSS评级均显著高于对照组(P<0.05),但Shaker组和CTAR组患者VFSS评级比较,差异无统计学意义(P>0.05)。治疗6周后,三组患者FOIS和SWAL-QOL评分均增高,且Shaker组和CTAR组患者FOIS和SWAL-QOL评分均显著高于对照组(P<0.05),但Shaker组和CTAR组患者FOIS和SWAL-QOL评分比较,差异均无统计学意义(P>0.05)。Shaker组和CTAR组患者临床治疗总有效率显著高于对照组(P<0.05),但Shaker组和CTAR组患者临床治疗总有效率比较,差异无统计学意义(P>0.05)。对照组不良反应发生率显著高于Shaker组和CTAR组(P<0.05),但Shaker组和CTAR组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:Shaker训练和CTAR训练在改善鼻咽癌患者放疗后吞咽障碍以及临床疗效上效果相似,且均能降低不良反应发生率,提高患者生存质量,在临床治疗中可根据患者实际情况选择合适的治疗方法。

Objective:To explore the application of Shaker training and CTAR training in the treatment of dysphagia after radiotherapy for nasopharyngeal carcinoma.Method:46 patients with nasopharyngeal carcinoma received dysphagia after radiotherapy from January 2017 to June 2018 were selected,patients were divided into control group(15 cases),Shaker group(15 cases)and CTAR group(16 cases)according to different treatment methods.The control group received routine swallowing training,Shaker group received Shaker training on the basis of the control group,and CTAR group received CTAR training on the basis of the control group.VFSS rating,FOIS score,SWAL-QOL score,clinical efficacy and adverse reactions were observed among the three groups.Result:2 weeks after treatment,VFSS ratings of the three groups were compared,the differences were not statistically significant(P>0.05);4 and 6 weeks after treatment,the VFSS ratings in the Shaker group and CTAR group were significantly higher than those in the control group(P<0.05),but the VFSS ratings in the Shaker group and CTAR group were not statistically significant(P>0.05).6 weeks after treatment,FOIS and SWALQOL scores of the three groups increased,and the FOIS and SWAL-QOL scores of the Shaker group and the CTAR group were significantly higher than those of the control group(P<0.05),but the differences between the FOIS and SWAL-QOL scores of the Shaker group and the CTAR group were not statistically significant(P>0.05).The total clinical response rate of Shaker group and CTAR group were significantly higher than those of the control group(P<0.05),but the comparison of the total clinical response rate of Shaker group and CTAR group showed no statistical significance(P>0.05).The incidence of adverse reactions in the control group was significantly higher than those in the Shaker group and CTAR group(P<0.05),but there was no significant difference in the incidence of adverse reactions between Shaker group and CTAR group(P>0.05).Conclusion:Shaker training and CTAR training have similar effects in improving dysphagia and clinical efficacy of patients with nasopharyngeal cancer after radiotherapy,and both can reduce the incidence of adverse reactions and improve the quality of life of patients,in clinical treatment,appropriate treatment methods can be selected according to the actual situation of patients.