吞咽功能训练对头颈部肿瘤放射治疗患者吞咽困难的效果

Effect of Swallowing Training on Dysphagia after Radiotherapy for Head and Neck Neoplasm

目的探讨吞咽功能训练对头颈部肿瘤放射治疗患者吞咽困难的干预效果。方法 2014年3月~2015年8月60例头颈部肿瘤患者随机分为干预组和对照组,每组各30例。对照组接受常规护理及相关健康教育,干预组在此基础上于放射治疗前2周至放射治疗结束后3个月进行吞咽功能训练。放射治疗结束后1周、3个月采用功能性经口摄食量表、安德森吞咽困难量表进行评价。结果放射治疗结束后1周,干预组患者功能性经口摄食量表得分（Z=-3.195,P〈0.01）、安德森吞咽困难量表总分及各维度评分（t〉4.385,P〈0.001）明显优于对照组。放射治疗结束后3个月,干预组患者功能性经口摄食量表得分（Z=-4.436,P〈0.01）、安德森吞咽困难量表总分及各维度评分（t〉5.361,P〈0.001）明显优于对照组。结论吞咽功能训练可改善头颈部肿瘤患者放射治疗引起的吞咽困难。

Objective To explore the effect of swallowing training on dysphagia in patients with head and neck neoplasm receiving radiotherapy. Methods 60 patients with head and neck neoplasm receiving radiotherapy from March, 2014 to August, 2015 were divided into intervention group（n=30） and control group（n=30） randomly. The control group received routine nursing and relevant health education,while the intervention group received swallowing training from 2 weeks before to 3 months after radiotherapy. They were assessed with Functional Oral Intake Scale and M. D. Anderson Dysphagia Inventory 1 week, 3 months after radiotherapy. Results The scores of Functional Oral Intake Scale（Z=-3.195, P〈0.01）, the total score of M. D. Anderson Dysphagia Inventory and the subscores（t4.385, P〈0.01） were better in the intervention group than in the control group 1 week after radiotherapy, as well as 3 months after radiotherapy（Z=-4.436, P〈0.01; t5.361, P〈0.01）. Conclusion Swallowing training could improve the condition of dysphagia of head and neck neoplasm patients after radiotherapy.