院外康复指导对鼻咽癌放化疗患者张口困难发生率的影响

Effects of post-hospital rehabilitation guidance on incidence rate of trismus in radiation and chemotherapy patients with nasopharyngeal carcinoma

目的:探讨QQ、电话康复锻炼指导对出院鼻咽癌放化疗患者张口困难发生率、发生程度及康复锻炼动作完整性的影响。方法:放化疗后92例鼻咽癌患者,随机分为QQ群干预组(32例)、电话干预组(30例)和对照组(30例),出院指导所有患者张口康复操锻炼、颞颌关节周边穴位按摩,有张口不适者中药热敷颞颌关节。出院后对两干预组持续6个月继续追踪督促、解释指导,对照组仅随访不再干预。结果:出院前张口困难发生率3组比较无统计学差异,出院后1个月QQ群干预组、电话干预组、对照组张口困难发生率分别为25.00%、36.67%、60.00%,5个月分别为0.00%、3.33%、16.67%,6个月分别为3.13%、3.33%、20.00%,两干预组与对照组比较有统计学差异(P<0.05)。结论:通过QQ群与电话对出院鼻咽癌患者实施院外康复锻炼指导,能有效减少张口困难的发生,QQ群干预组康复锻炼依从性更好。

Objective： To evaluate the effects of incidence and the degree of trismus and rehabilitation exercises integrity by QQ and telephone on discharged patients with nasopharyngeal carcinoma completed chemotherapy. Methods： 92 discharged patients with nasopharyngeal carcinoma were randomly divided into QQ intervention group （32 cases）,telephone intervention group （30 cases） and control group （30 cases）. All the patients of 3 groups were implemented guide about mouth exercise, acupuncture massage around temporomandibular joint and hot applications with Chinese medicine. The patients of 2 intervention groups were conducted with persistent nursing intervention for 6 months after discharge, while the patients of control group were only followed-up and no intervention. Results： The trismus rates of QQ intervention group, telephone intervention group and control group were 25.00%, 36.67% and 60.00% respectively a month after discharge, and that were 0.00% ,3.33% ,16.67% in 5 months, 3.13% ,3.33% ,20.00% in 6 months. There were significant differences within the intervention groups and the control group（P〈0.05）. Conclusion： Persistent nursing intervention of traditional Chinese medicine conducted with QQ and telephone could help discharged patients to reduce the occurrence of trismus. And QQ intervention could help the patients insist on rehabilitation training more effectively.