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电刺激与运动疗法对头颈癌患者吞咽困难的疗效:一项随机临床试验。

Efficacy of electrical stimulation and exercise for dysphagia in patients with head and neck cancer: A randomized clinical trial.

作者信息

Langmore Susan E, McCulloch Timothy M, Krisciunas Gintas P, Lazarus Cathy L, Van Daele Douglas J, Pauloski Barbara Roa, Rybin Denis, Doros Gheorghe

机构信息

Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts.

Department of Speech Language Hearing, Boston University, Boston, Massachusetts.

出版信息

Head Neck. 2016 Apr;38 Suppl 1(Suppl 1):E1221-31. doi: 10.1002/hed.24197. Epub 2015 Oct 15.

Abstract

BACKGROUND

Neuromuscular electrical stimulation (NMES) is a highly sought after but poorly studied treatment for dysphagia among patients with head and neck cancer with dysphagia. This study investigated the efficacy of NMES in this patient population.

METHODS

In this double-blinded, randomized controlled trial, 170 patients with head and neck cancer experiencing posttreatment dysphagia were randomized into active NMES + swallow exercise versus sham NMES + swallow exercise groups. Outcomes after a 12-week program included changes in fluoroscopy measures, diet, and quality of life.

RESULTS

After the 12-week program, the active NMES group had significantly worse Penetration Aspiration Scale scores than the sham group. Both groups reported significantly better diet and quality of life. No other measures were significant.

CONCLUSION

NMES did not add benefit to traditional swallow exercises. Unfortunately, swallow exercises were not effective by themselves either. For patients with head and neck cancer with moderate to severe dysphagia caused by radiation therapy, current behavioral therapies are of limited help in reversing long-term dysphagia. © 2015 Wiley Periodicals, Head Neck 38: E1221-E1231, 2016.

摘要

背景

神经肌肉电刺激(NMES)是头颈癌吞咽困难患者备受关注但研究较少的一种治疗方法。本研究调查了NMES对该患者群体的疗效。

方法

在这项双盲随机对照试验中,170名头颈癌治疗后出现吞咽困难的患者被随机分为主动NMES + 吞咽训练组与假NMES + 吞咽训练组。12周方案后的结果包括透视测量、饮食和生活质量的变化。

结果

12周方案结束后,主动NMES组的渗透误吸量表得分显著低于假刺激组。两组均报告饮食和生活质量有显著改善。其他测量指标均无显著差异。

结论

NMES并未给传统吞咽训练带来额外益处。不幸的是,吞咽训练本身也无效。对于因放疗导致中重度吞咽困难的头颈癌患者,目前的行为疗法在逆转长期吞咽困难方面帮助有限。© 2015年威利期刊公司,《头颈》38: E1221 - E1231,2016年

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