Messing Barbara Pisano, Ward Elizabeth C, Lazarus Cathy L, Kim Melissa, Zhou Xian, Silinonte Jessica, Gold Dorothy, Harrer Karen, Ulmer Karen, Merritt Samantha, Neuner Geoffrey, Levine Marshall, Blanco Ray, Saunders John, Califano Joseph
The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
Dysphagia. 2017 Aug;32(4):487-500. doi: 10.1007/s00455-017-9790-6. Epub 2017 Apr 25.
Evidence supporting prophylactic swallow exercises for patients with head and neck cancer (HNC) has not been universally demonstrated. This RCT examined diet level, feeding tube use, swallow function, and quality of life (QOL) of patients undergoing chemoradiotherapy who performed prophylactic swallowing exercises. Sixty HNC patients were randomized into exercise versus control groups. Swallowing, oromotor, toxicity, and QOL data were recorded (baseline, 3, 6, 12, 24 months). Physiological swallow function was examined at baseline and 3 months. Swallow exercises were completed twice daily. Oral intake at 3 months was 10% better in the exercise group, which was not statistically significant (p = 0.49). Significant (p < 0.05) differences in secondary outcomes including oromotor function, pharyngeal impairment, oral pharyngeal swallow efficiency, and incisal opening were noted at early time points (3-6 months) in the exercise group. Possible positive early improvements in swallow function are associated with swallowing exercises, although these improvements are not significant longer term.
支持对头颈部癌症（HNC）患者进行预防性吞咽训练的证据尚未得到普遍证实。这项随机对照试验研究了进行预防性吞咽训练的接受放化疗的患者的饮食水平、饲管使用情况、吞咽功能和生活质量（QOL）。60名HNC患者被随机分为训练组和对照组。记录吞咽、口腔运动、毒性和生活质量数据（基线、3、6、12、24个月）。在基线和3个月时检查生理吞咽功能。吞咽训练每天完成两次。训练组在3个月时的经口摄入量比对照组高10%，但无统计学意义（p = 0.49）。在早期时间点（3 - 6个月），训练组在包括口腔运动功能、咽部损伤、口咽吞咽效率和切牙开口等次要结局方面存在显著（p < 0.05）差异。吞咽训练可能会在早期对吞咽功能产生积极改善，尽管这些改善在长期并不显著。
