预防性吞咽干预在喉部分切除术患者中的应用研究

Effectiveness of prophylactic swallowing interventions in patients with partial laryngectomy

目的探讨预防性吞咽干预模式在喉部分切除术患者中的应用效果。方法采用便利抽样法,选取2020年8月—2022年2月长春市某三级甲等医院耳鼻咽喉头颈外科首次行喉部分切除术的患者80例,按入院顺序分为试验组和对照组各40例。试验组在对照组干预措施的基础上进行院内与家庭康复,实施为期1个月的联合下颌抗阻与呼吸-吞咽协调训练模式的预防性吞咽干预;对照组给予常规护理及基础吞咽训练。比较入组前1 d,术后14 d及1个月两组吞咽安全性、吞咽-经口摄食功能以及生活质量的差异。结果试验组38例,对照组37例完成研究。两组吞咽安全性、吞咽-经口摄食功能及生活质量的时间、组间及交互效应均具有统计学意义(P<0.05),术后14 d和1个月试验组各指标均优于对照组(P<0.05)。结论预防性下颌抗阻与呼吸-吞咽协调训练模式联合干预能够提高喉部分切除患者吞咽的安全性,改善吞咽功能,恢复功能性经口摄食,提升生活质量,促进早期康复。

Objective To explore the effect of preventive swallowing interventions in patients with partial laryngectomy.Methods Using convenience sampling method,75 patients who underwent partial laryngectomy for the first time in a tertiary hospital in Changchun from August 2020 to February 2022 were selected.They were divided into an experimental group(n=38)and a control group(n=37)according to the order of admission time.The control group was given routine care and basic swallowing training.The experimental group was given a combined intervention of Chin tuck against resistance and respiratory-swallowing coordination model on the basis of the control group,combined with in-hospital and out-of-hospital family rehabilitation for 1 month of preventive swallowing exercise.The differences in swallowing safety,swallowing-oral feeding function and quality of life between the 2 groups were compared at a day before enrollment,14 days after operation and 1 month after operation.Results The time,grouping and interaction effect of swallowing safety,swallowing-oral feeding and quality of life in the 2 groups were statistically significant(P<0.05).The indexes of the experimental group were better than those in the control group at 14 days and 1 month after partial laryngectomy(P<0.05).Conclusion The combined intervention model of preventive Chin tuck against resistance and respiratory-swallowing coordination exercise can enhance swallowing safety,swallowing function,restore functional oral feeding,facilitate quality of life,and promote early rehabilitation in patients with partial laryngectomy.