容积-黏度吞咽测试联合摄食细节护理在口腔癌游离皮瓣移植术后患者中的应用

Application of volumetric-viscosity swallow test combined with feeding detail nursing in patients with oral cancer after free flap transplantation

目的探讨基于容积-黏度吞咽测试联合摄食细节护理在口腔癌游离皮瓣移植术后患者中的应用价值。方法选取90例山西省肿瘤医院头颈外科2022年7月至2023年12月的口腔癌游离皮瓣移植术后患者作为研究对象,按照随机数字表法分为对照组和研究组,每组45例。对照组在患者病情稳定后进行常规吞咽功能训练,研究组在对照组训练基础上实施基于容积-黏度吞咽测试联合摄食细节护理。比较两组患者吞咽功能、住院时间、胃管留置时间、营养状况、并发症发生情况及护理满意度。结果两组患者干预前的标准吞咽功能量表(SSA)和改良曼恩吞咽能力评估量表(MASA)评分差异无统计学意义(P>0.05);干预后研究组患者MASA评分明显高于对照组,SSA评分明显低于对照组(均P<0.001);研究组患者住院时间及留置胃管时间显著低于对照组(均P<0.05);干预1个月后研究组患者白蛋白(ALB)和血红蛋白(Hb)水平明显高于对照组(P<0.001);研究组误吸、呛咳及吸入性肺炎并发症总发生率低于对照组(P=0.041);研究组患者的护理满意度评分明显高于对照组(P=0.026)。结论容积-黏度吞咽测试联合摄食细节护理可以提高患者吞咽功能,缩短住院时间及留置胃管时间,改善患者的营养状况,降低并发症发生率及提高患者护理满意度。

Objective To explore the application value of volume-viscosity swallow test combined with detailed feeding care in patients after free flap transplantation for oral cancer.Methods Ninety patients who underwent free flap transplantation for oral cancer in the Department of Head and Neck Surgery at Shanxi Cancer Hospital from July 2022 to December 2023 were selected as study subjects.The patients were randomly assigned to either a control group or a study group,with 45 patients in each group,using a random number table method.The control group received conventional swallowing function training after their condition stabilized,while the study group received the same training as the control group combined with volume-viscosity swallow test-based and detailed feeding care.Swallowing function,length of hospital stays,duration of nasogastric tube placement,nutritional status,incidence of complications,and nursing satisfaction were compared between the two groups.Results There were no statistically significant differences in the standard swallowing assessment(SSA)and modified Mann assessment of swallowing ability(MASA)scores between the two groups before the intervention(P>0.05).After the intervention,the MASA scores in the study group were significantly higher,while the SSA scores were significantly lower compared to the control group(both P<0.001).The length of hospital stay and duration of nasogastric tube placement were significantly shorter in the study group than in the control group(both P<0.05).One month after the intervention,albumin(ALB)and hemoglobin(Hb)levels were significantly higher in the study group than in the control group(P<0.001).The total incidence of complications,including aspiration,coughing,and aspiration pneumonia,was lower in the study group than in the control group(P=0.041).The nursing satisfaction scores in the study group were significantly higher than those in the control group(P=0.026).Conclusion The V-VST combined with detailed feeding care can improve patients'swallowing function,shorten hospital stay and nasogastric tube placement time,enhance nutritional status,reduce the incidence of complications,and increase patient nursing satisfaction.