García-Peris P, Parón L, Velasco C, de la Cuerda C, Camblor M, Bretón I, Herencia H, Verdaguer J, Navarro C, Clave P
Nutrition Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Clin Nutr. 2007 Dec;26(6):710-7. doi: 10.1016/j.clnu.2007.08.006. Epub 2007 Oct 22.
BACKGROUND & AIMS: To determine the prevalence of dysphagia in head and neck cancer patients treated with surgery and radiotherapy or chemoradiotherapy. To study the impact of dysphagia on food habits, nutritional status, and quality of life.
Retrospective cross-sectional study of 87 head and neck cancer patients treated with surgery and radiotherapy or chemoradiotherapy from January 2000 through May 2005. Time since surgery was 28.5+/-17.8 months. A clinical test was used to detect dysphagia. A nutritional assessment was performed in all patients. A questionnaire was used to evaluate quality of life.
Oropharyngeal dysphagia was present in 50.6% of patients, mostly to solid foods (72.4%). Patients with total glossectomy and chemoradiotherapy had the highest rate of dysphagia. Nutritional support was necessary in 57.1% of patients. Malnutrition was present in 20.3% of patients, mainly marasmus (81%). Fifty-one percent of patients reported a decrease in their quality of life due to dysphagia.
We found a high prevalence of dysphagia in head and neck cancer patients treated with surgery and coadjuvant treatment. This problem negatively affects their quality of life. It is important that nutritional surveillance be provided to detect it and to prevent malnutrition.
确定接受手术及放疗或放化疗的头颈癌患者吞咽困难的患病率。研究吞咽困难对饮食习惯、营养状况及生活质量的影响。
对2000年1月至2005年5月间接受手术及放疗或放化疗的87例头颈癌患者进行回顾性横断面研究。术后时间为28.5±17.8个月。采用临床检查检测吞咽困难。对所有患者进行营养评估。使用问卷评估生活质量。
50.6%的患者存在口咽吞咽困难，主要是固体食物吞咽困难（72.4%）。全舌切除术及放化疗患者吞咽困难发生率最高。57.1%的患者需要营养支持。20.3%的患者存在营养不良，主要是消瘦（81%）。51%的患者报告因吞咽困难导致生活质量下降。
我们发现接受手术及辅助治疗的头颈癌患者吞咽困难患病率很高。这个问题对他们的生活质量有负面影响。提供营养监测以发现并预防营养不良很重要。
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