口腔神经肌肉训练联合间歇性θ短阵脉冲刺激在鼻咽癌放化疗后吞咽障碍患者中的应用

Effect of oral neuromuscular training combined with intermittentθburst stimulation on dysphagia of nasopharyngeal carcinoma patients after chemoradiotherapy

目的探究口腔神经肌肉训练联合间歇性θ短阵脉冲刺激(iTBS)在鼻咽癌化疗后吞咽障碍患者中的应用价值。方法将空军军医大学第二附属医院2021年3月至2022年3月收治的76例行放化疗后存在吞咽障碍的鼻咽癌患者纳为研究对象,通过随机数字表法将其分为观察组与对照组,其中对照组患者进行常规吞咽训练,观察组采用口腔神经肌肉训练加iTBS刺激,采用电视荧光吞咽检查(VFSS)与Rosenbek渗漏/误吸量表(PAS)比较2组干预前后吞咽功能,比较2组干预后生活质量及治疗效果。结果观察组与对照组患者经干预后,吞咽功能评估量表PAS量表得分均较同组干预前下降,吞咽生命质量量表(SWAL-QOL)得分均较同组干预前升高,且与对照组干预后比较,观察组干预后PAS量表得分更低,SWAL-QOL得分更高,差异均有统计学意义(P<0.05)。观察组吞咽困难治疗总有效率(86.84%)高于对照组(44.74%),差异具有统计学意义(P<0.05)。结论口腔神经肌肉训练联合iTBS能有效改善鼻咽癌放化疗患者吞咽障碍,提高其生活质量。

Objective To explore the effect of oral neuromuscular training combined with intermittent theta burst stimulation(iTBS)on dysphagia of nasopharyngeal carcinoma patients after chemoradiotherapy.Methods Seventy-six nasopharyngeal carcinoma patients with dysphagia who received chemoradiotherapy in The Second Affiliated Hospital of Air Force Medical University from March 2021 to March 2022 were enrolled and divided into two groups by random number table methods.Control group received conventional swallowing training,and observation group received oral neuromuscular training combined with iTBS.The swallowing function was assessed by video fluoroscopic swallowing study(VFSS)and Rosenbek penetration aspiration scale(PAS)at the baseline and after treatment.The quality of life and treatment effect were compared between the two groups.Results After intervention,the PAS score was decreased and the Swallowing Quality-of-Life Questionnaire(SWAL-QOL)score was increased in both groups(P<0.05),with significant differences between the two groups(P<0.05).The treatment efficacy of dysphagia in the observation group was significantly higher than that in the control group(86.84%vs 44.74%,P<0.05).Conclusion Oral neuromuscular training combined with iTBS can effectively ameliorate dysphagia and improve the quality of life of patients with nasopharyngeal carcinoma after chemoradiotherapy.