头颈肿瘤放疗后吞咽障碍患者间歇经口管饲的有效性

Efficacy of intermittent oral gavage in patients with dysphagia after radiotherapy for head and neck tumors

目的:研究头颈肿瘤放疗后吞咽障碍患者间歇经口管饲的有效性。方法:选取2015年2月至2019年2月我院收治的80例头颈肿瘤放疗后吞咽障碍患者,根据入院顺序不同分组,各40例。对照组常规留置胃管鼻饲,观察组予以间歇经口管饲,比较两组干预前后营养状态指标[血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、转铁蛋白(TRF)]、吞咽功能变化、注食时和非注食时Kolcaba的舒适状况量表评分、吞咽困难生命质量测量工具评分(SWAL-QOL)、患者尊严量表评分(PDI)、并发症发生率。结果:两组干预前后Hb、TP、ALB、TRF组间比较差异无统计学意义(P>0.05);观察组优良率(92.50%)较对照组(65.00%)高(P<0.05);两组注食时Kolcaba的舒适状况量表评分比较差异无统计学意义(P>0.05);观察组非注食时Kolcaba的舒适状况量表评分高于对照组(P<0.05);对照组干预后PDI评分较干预前升高(P<0.05);观察组干预前后PDI评分比较差异无统计学意义(P>0.05);观察组干预后SWAL-QOL、PDI评分低于对照组(P<0.05);观察组并发症发生率(2.50%)较对照组(20.00%)低(P<0.05)。结论:头颈肿瘤放疗后吞咽障碍患者采用间歇经口管饲,可保证机体营养供给,促进吞咽功能恢复,保留患者尊严,提高患者舒适度、生存质量,减少并发症的发生。

Objective:To study the effectiveness of intermittent oral gavage in patients with dysphagia after radiotherapy for head and neck tumors.Methods:80 patients with dysphagia after radiotherapy for head and neck cancer were enrolled in our hospital from February 2015 to February 2019.According to the order of admission,40 patients were included.In the control group,gastric tube nasal feeding was routinely indwelled,and the observation group was given intermittent oral gavage.The nutritional status indicators[hemoglobin(Hb),total protein(TP),albumin(ALB),transferrin(TRF)]were compared before and after intervention.Kolcaba's comfort status scale,dysphagia quality of life measurement tool score(SWAL-QOL),patient dignity scale score(PDI),and complication rate were observed during swallowing function changes,feeding and non-feeding.Results:There were no significant differences in Hb,TP,ALB and TRF between the two groups before and after intervention(P>0.05).The excellent and good rate of the observation group(92.50%)was higher than that of the control group(65.00%)(P<0.05).There was no significant difference in Kolcaba's comfort status scores between the two groups(P>0.05).Kolcaba's comfort status score was higher in the observation group than in the control group(P<0.05).The PDI scores of the control group was higher after intervention than before(P<0.05).There was no significant difference in PDI scores before and after intervention in the observation group(P>0.05).The SWAL-QOL and PDI scores of the observation group were lower than those of the control group(P<0.05).The incidence of complications in the observation group(2.50%)was lower than that in the control group(20.00%)(P<0.05).Conclusion:Patients with dysphagia after radiotherapy for head and neck tumors with intermittent oral tube feeding to ensure nutrient supply,promote swallowing function recovery,preserve patient dignity,improve patient comfort,quality of life and reduce complications.