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[晚期头颈癌患者的预处理吞咽困难]

[Pretreatment dysphagia in patients with advanced head and neck cancer].

作者信息

Martín Villares C, Tapia Risueño M, San Román Carbajo J, Fernández Pello M E, Domínguez Calvo J

机构信息

Servicio de ORL, Hospital de Bierzo, La Dehesa, s/n. 24400 Ponferrada, León.

出版信息

Nutr Hosp. 2003 Sep-Oct;18(5):238-42.

Abstract

OBJECTIVE

To define swallowing dysfunctions in head and neck cancer patients with respect to tumor site.

PATIENTS AND METHODS

A consecutive cohort of 52 patients with stage III-IV head and neck cancer without prior tracheotomy or treatment were studied according to tumor site: oral cavity (n = 8), oropharynx (n = 8), hypopharynx (n = 13) and larynx (23). All patients underwent nasoendoscopy prior to treatment. Swallowing function (dysphagia, aspiration and Swallowing Performance Status Seale score) was analyzed with reference to tumor localization using chi 2 and Fisher exact tests.

RESULTS

Laryngeal and hypopharyngeal neoplasms neoplasms showed the most severe pre-treatment swallowing dysfunction (27% pre-treatment vs. 11% post-treatment), and oral and oropharyngeal neoplasms showed the most severe post-treatment swallowing dysfunction (6% pretreatment vs. 68% post-treatment). Aspiration and tumor localization revealed not statistically significant differences between groups. Pre-treatment dysphagia did not correlate with post-treatment dysphagia.

CONCLUSIONS

Laryngeal and hypopharyngeal neoplasms showed severe pre-treatment swallowing dysfunctional and oral and oropharyngeal neoplasms showed severe post-treatment swallowing dysfunction.

摘要

目的

根据肿瘤部位确定头颈癌患者的吞咽功能障碍情况。

患者与方法

对52例未经气管切开术或治疗的III-IV期头颈癌患者进行连续队列研究,根据肿瘤部位分为:口腔癌(n = 8)、口咽癌(n = 8)、下咽癌(n = 13)和喉癌(23例)。所有患者在治疗前均接受鼻内镜检查。采用卡方检验和Fisher精确检验,参照肿瘤定位分析吞咽功能(吞咽困难、误吸和吞咽功能状态评分)。

结果

喉癌和下咽癌患者治疗前吞咽功能障碍最为严重(治疗前27% vs. 治疗后11%),口腔癌和口咽癌患者治疗后吞咽功能障碍最为严重(治疗前6% vs. 治疗后68%)。误吸与肿瘤定位在组间差异无统计学意义。治疗前吞咽困难与治疗后吞咽困难无相关性。

结论

喉癌和下咽癌患者治疗前吞咽功能障碍严重,口腔癌和口咽癌患者治疗后吞咽功能障碍严重。

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