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通过手术封闭喉部来提高严重吞咽困难患者的生活质量。

Improving the Quality of Life of Patients With Severe Dysphagia by Surgically Closing the Larynx.

作者信息

Kimura Yurika, Kishimoto Seiji, Sumi Takuro, Uchiyama Mio, Ohno Keiko, Kobayashi Hitome, Kano Makoto

机构信息

1 Department of Otolaryngology, Ebara Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Ota-ku, Tokyo, Japan.

2 Department of Otolaryngology, Showa University, Shinagawa-ku, Tokyo, Japan.

出版信息

Ann Otol Rhinol Laryngol. 2019 Feb;128(2):96-103. doi: 10.1177/0003489418808300. Epub 2018 Oct 22.

Abstract

OBJECTIVES

: The aim of this study was to elucidate the utility of the Kano method with surgical closure of the larynx by cricoid cartilage removal in improving quality of life in patients with severe dysphagia and their caregivers.

METHODS

: Nine patients with severe dysphagia who underwent the Kano method were evaluated for oral intake and activities of daily living using the functional oral intake scale and the Barthel index, respectively, as indices of quality of life. Additionally, nutritional status, inflammation, and postoperative complications were assessed. Furthermore, 7 family caregivers were queried regarding frequency of sputum suction, mood of family caregivers, and postoperative satisfaction.

RESULTS

: Functional oral intake scale and Barthel index scores as well as inflammation improved significantly after surgery ( P < .05). There were no severe complications or other complications requiring surgical intervention. The frequency of sputum suction was reduced postoperatively ( P < .05). The mood of family caregivers was significantly improved and satisfaction level was high postoperatively.

CONCLUSIONS

: Surgical closure of the larynx is an appropriate choice for patients with irreversible severe dysphagia and impaired articulation or vocal function because quality of life is improved for both patients and family caregivers and the satisfaction of family caregivers is sufficient.

摘要

目的

本研究旨在阐明通过环状软骨切除术进行喉部手术闭合的卡诺方法在改善重度吞咽困难患者及其护理人员生活质量方面的效用。

方法

对9例接受卡诺方法治疗的重度吞咽困难患者,分别使用功能性经口进食量表和巴氏指数评估经口摄入量和日常生活活动能力,作为生活质量指标。此外,还评估了营养状况、炎症和术后并发症。此外,询问了7名家庭护理人员关于吸痰频率、家庭护理人员的情绪和术后满意度。

结果

术后功能性经口进食量表和巴氏指数评分以及炎症均有显著改善(P <.05)。没有严重并发症或需要手术干预的其他并发症。术后吸痰频率降低(P <.05)。家庭护理人员的情绪有显著改善,术后满意度较高。

结论

对于不可逆的重度吞咽困难且发音或发声功能受损的患者,喉部手术闭合是一种合适的选择,因为患者和家庭护理人员的生活质量均得到改善,且家庭护理人员的满意度较高。

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