食管癌根治术后患者阶段性综合吞咽训练方案的优化与实施

Optimization and implementation of stepwise comprehensive swallowing training program for patients after radical surgery for esophageal cancer

目的探讨阶段性综合吞咽训练在食管癌根治术患者中的应用效果。方法选取胸外科住院食管癌术后患者60例,按照病区随机分为干预组和对照组各30例。干预组实施阶段性综合吞咽训练方案,对照组实施常规吞咽康复护理方案。比较两组术后首次经口进食时间、吞咽功能、摄食能力、营养相关指标以及吞咽障碍相关并发症发生率。结果两组均完成研究,干预组首次经口进食时间、吞咽障碍相关并发症发生率显著短于和低于对照组,术后吞咽功能和摄食能力得分及营养相关指标显著优于对照组(均P<0.05)。结论阶段性综合吞咽训练方案的实施有利于促进食管癌根治术后患者吞咽功能恢复,改善术后营养状态,降低吞咽障碍相关并发症发生率。

Objective To explore the effect of stepwise comprehensive swallowing training in patients after radical resection for esophageal cancer.Methods Two units of the department of thoracic surgery were randomized into 2 groups per cluster randomization method.Then 60 patients admitted to the 2 units were selected and enrolled into 2 groups,with 30 cases in each group.The intervention group was subjected to a stepwise comprehensive swallowing training program,while the control group was subjected to routine swallowing rehabilitation care.The time to first oral intake after surgery,swallowing function,oral intake capacity,nutrition-related indicators,and the incidence rates of dysphagia-related complications in two groups were compared between 2 groups.Results All cases completed the study in both groups.The time to first oral intake was significantly shorter and the incidence rate of dysphagia-related complications was significantly lower in the intervention group than those in the control group;the former group had better swallowing function scores and oral intake capacity scores,as well as better nutrition-related indicators,than the latter group did(P<0.05 for all).Conclusion Implementation of stepwise comprehensive swallowing training program can promote the recovery of swallowing function,improve postoperative nutritional status and reduce the incidence of dysphagia-related complications in patients after radical resection for esophageal cancer.