吞咽训练在口腔癌术后加速康复中的效果评价

The Evaluation of Swallowing Training in the Accelerated Rehabilitation of Patients with Oral Cancer

目的:主要通过早期吞咽功能训练对患者吞咽功能恢复影响的研究。方法:研究通过选取2017年8月~2018年11月来本院进行治疗的31位口腔癌患者为对象,在手术72小时后,指导患者行吞咽训练方法。采用洼田饮水试验评估患者吞咽障碍程度,同时进行MASA评估,确定患者在进行吞咽训练前后是否有明显差异。结果:通过MASA评级表明,25位患者在吞咽训练前后有着明显的差异,吞咽训练前平均得分为88.91±0.783,吞咽训练后平均得分为94.25±0.598。对于另外6位没有接受术后训练的口腔癌患者,通过洼田饮水试验评级表明,其术后吞咽功能没有明显改变。结论:术后早期吞咽训练是可以帮助患者尽快改善吞咽功能,进而让他们提前拆除鼻饲管,减少吸入性肺炎发生的概率,最终降低吞咽困难对患者心理和生理的影响,提高患者的生活质量,对患者营养状况的改善起到积极的效果。因此,医院应该将吞咽训练作为口腔癌患者术后恢复的一个重要环节。

Objective: To study the effect of early swallowing training on the recovery of swallowing function. Methods: In this study, 31 patients with oral cancer who were treated in our hospital from August 2017 to November 2018 were selected as subjects. After 72 hours of operation, the patients were instructed in swallowing training methods. Wada drinking water test was used to evaluate the degree of dysphagia, and Masa was used to determine whether there was significant difference before and after swallowing training. Results: According to the Masa rating, 25 patients had significant differences before and after swallowing training. The average score before swallowing training was 88.91±0.783, and after swallowing training was 94.25±0.598. For the other six patients who did not receive postoperative training, the rating of Wada drinking water test showed that their swallowing function did not change significantly. Conclusion: Early postoperative swallowing training can help patients to improve their swallowing function as soon as possible, so that they can remove the nasogastric tube in advance, reduce the probability of aspiration pneumonia, ultimately reduce the psychological and physiological impact of dysphagia on patients, improve the quality of life of patients, and improve the nutritional status of patients. Therefore, swallowing training should be an important part of postoperative recovery for patients with oral cancer.