摘要
目的:舌癌术后舌缺损患者往往存在不同程度的吞咽困难,严重影响患者的生存质量,患者最终多因并发吸入性肺炎、恶病质死亡。本病例报告将尝试寻找1种有效的吞咽障碍治疗方法来解决这一临床问题。诊疗经过:1例舌癌术后患者出现舌缺损伴吞咽障碍,口腔医师利用舌接触辅助装置重塑硬腭形态,改善吞咽过程中舌与硬腭的接触,同时结合抗阻力康复训练,加强剩余舌骨上肌群的力量,以提高舌癌术后舌缺损患者的吞咽功能,并评估该方法的有效性及可行性。结果:干预后3个月,洼田饮水实验提升为Ⅱ级,语音速度检测为6±1,基本达到舌癌术前水平,患者整体舌运动范围增加,灵活度也明显提高。结论:舌接触辅助装置结合抗阻力训练能够有效改善舌癌术后舌缺损患者的吞咽功能。
Objective:Patients with tongue defects after oral cancer and oropharyngeal cancer often have varying degrees of dysphagia,which seriously affects the quality of life of patients.Most patients eventually die due to concurrent aspiration pneumonia and cachexia.This research aims to find an effective treatment for dysphagia to solve this clinical problem.Diagnosis and treatment:In this case,the maxillary prosthetic device was used to reshape the shape of the hard palate to improve the contact between the tongue and the hard palate during swallowing.At the same time,combined with Shaker rehabilitation training,the strength of the remaining suprahyoid muscles was strengthened to improve the swallowing function of patients with tongue defects after oral cancer surgery.At the same time,the validity and feasibility of this method are evaluated.Results:The water swallow test was upgraded to level II,with a speech speed detection of 6±1,which basically reached the preoperative level.The overall range of tongue movement of the patient was significantly increased,and the flexibility was also significantly improved after 3 months of intervention.Conclusions:The combination of palatal augmentation prosthesis(PAP)and Shaker exercise can effectively improve the swallowing function of patients with tongue defects after tongue cancer surgery.
作者
李娜
高宁
付坤
蔡菁华
高振杰
赵斌
何巍
Na Li;Ning Gao;Kun Fu;Jinghua Cai;Zhenjie Gao;Bin Zhao;Wei He(Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Zhengzhou University,School of Stomatology,Zhengzhou University,Henan Stomatological Center,Zhengzhou,Henan Province,P.R.China.)
出处
《中国口腔医学继续教育杂志》
2023年第5期398-402,410,共6页
Chinese Journal of Stomatologial Continuing Education
基金
河南省科技攻关项目(项目编号:232102311197)
河南省医学教育研究项目(项目编号:Wjlx2020170)。
关键词
舌癌
舌缺损
吞咽障碍
舌接触辅助装置
抗阻力训练
tongue cancer
tongue defect
swallowing disorder
palatal augmentation prosthesis(PAP)
Shaker exercise