分段式干预对喉部分切除术后喉癌患者吞咽功能及生活质量的影响

Effect of segmented intervention on swallowing function and quality of life in patients with laryngeal cancer after partial laryngectomy

目的探讨分段式干预对喉部分切除术后喉癌患者吞咽功能和生活质量的影响。方法将2020年3月至2021年2月采用常规术后干预的51例喉部分切除术后喉癌患者纳入常规组,将2021年3月至2022年3月采用分段式干预的54例喉部分切除术后喉癌患者纳入分段组。比较两组患者MD安德森吞咽困难量表(MDADI)、嗓音障碍指数(VHI)、头颈癌患者生命质量量表(QLICP-HN)评分,比较两组患者洼田饮水试验结果及术后并发症发生情况。结果干预后,两组患者MDADI各维度评分及总分均升高,且分段组患者MDADI各维度评分及总分均高于常规组,差异均有统计学意义(P<0.05)。干预后,两组患者VHI各维度评分及总分均降低,且分段组患者VHI各维度评分及总分均低于常规组,差异均有统计学意义(P<0.05)。干预后,两组患者QLICP-HN各维度评分均升高,且分段组患者QLICP-HN各维度评分均高于常规组,差异均有统计学意义(P<0.05)。干预后,分段组患者洼田饮水试验结果优于常规组,术后并发症总发生率低于常规组,差异均有统计学意义(P<0.05)。结论分段式干预可提高喉部分切除术后喉癌患者吞咽功能与嗓音质量恢复效果,改善患者生活质量,降低术后并发症发生风险。

Objective To investigate the effect of segmented intervention on swallowing function and quality of life in patients with laryngeal cancer after partial laryngectomy.Method Fifty-one patients with laryngeal cancer after par-tial laryngectomy who underwent routine postoperative intervention from March 2020 to February 2021 were included in the conventional group,fifty-four patients with laryngeal cancer after partial laryngectomy who underwent the segmented intervention from March 2021 to March 2022 were included in the segmented group.The scores of the MD Anderson dys-phagia inventory(MDADI),voice handicap index(VHI),quality of life instruments for cancer patients-head and neck cancer(QLICP-HN)were compared,and the results of the Watian drinking water test and the occurrence of postoperative complications were also compared between the two groups.Result After the intervention,the scores of each dimension and total score of MDADI of the two groups were increased,and the scores of each dimension and total score of MDADI in the segmented group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).After the intervention,the scores of each dimension and total score of VHI of the two groups were reduced,and the scores of each dimension and total score of VHI in the segmented group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).After the intervention,the scores of each dimension and total score of QLICP-HN of the two groups were increased,and the scores of each dimension and total score of QLICP-HN in the segmented group were higher than those in the conventional group,and the differences were statistically signifi-cant(P<0.05).After the intervention,the result of the Watian drinking water test in the segmented group was better than that in the conventional group,and the total incidence of postoperative complications was lower than that in the conven-tional group,and the differences were statistically significant(P<0.05).Conclusion Segmented intervention could im-prove the swallowing function and voice quality recovery effect of laryngeal cancer patients after partial laryngectomy,improve their quality of life,and reduce the risk of postoperative complications.