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喉癌患者部分喉切除术后吞咽功能及吞咽相关生活质量的调查。

Investigation of swallowing function and swallowing-related quality of life after partial laryngectomy in Chinese patients with laryngeal carcinoma.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

出版信息

Health Qual Life Outcomes. 2019 Jul 26;17(1):132. doi: 10.1186/s12955-019-1199-5.

Abstract

BACKGROUND

Swallowing function and swallowing-related quality of life (QoL) can be adversely affected in patients after partial laryngectomy, but are often neglected by patients and clinical workers. This study aimed to investigate the degree of swallowing function and swallowing-related QoL after partial laryngectomy in patients with laryngeal carcinoma.

METHODS

Sixty-eight hospitalized patients undergoing partial laryngectomy due to laryngeal carcinoma at the Second Affiliated Hospital of Xi'an Jiao Tong University were included in this prospective study. A general information questionnaire was used to collect baseline characteristics. The water swallow test and swallowing quality of life questionnaire (SWAL-QOL) were carried out the day before surgery and at 2, 4, 12, 24 and 48 weeks after surgery.

RESULTS

Swallowing dysfunction occurred in 1 case (1.5%) the day before surgery and in 49 (72.1%), 44 (64.7%), 33 (49.3%), 19 (28.4%) and 8 (11.9%) cases at 2, 4, 12, 24 and 48 weeks after surgery, respectively. Mean SWAL-QOL total scores were 4266.3 ± 232.0 the day before surgery, and 1992.9 ± 1062.4, 2473.9 ± 962.9, 3169.2 ± 753.6, 3696.7 ± 718.3 and 3910.8 ± 1510.4 at 2, 4, 12, 24 and 48 weeks, respectively. SWAL-QOL total scores increased gradually after operation, and the differences were statistically significant (P < 0.05). There was no statistical difference between postoperative 24 and 48 weeks (P = 0.379).

CONCLUSIONS

Partial laryngectomy affects swallowing function and swallowing-related QoL in patients with laryngeal carcinoma. While swallowing function and swallowing-related QoL increase gradually over time, in some patients, nearly a year after surgery they are not fully restored. Therefore, attention should be paid during postoperative nursing to improve swallowing function.

摘要

背景

喉部分切除术后患者的吞咽功能和吞咽相关生活质量(QoL)可能会受到不利影响,但常被患者和临床工作者忽视。本研究旨在探讨喉癌患者喉部分切除术后的吞咽功能和吞咽相关 QoL 程度。

方法

本前瞻性研究纳入了在西安交通大学第二附属医院因喉癌行喉部分切除术的 68 例住院患者。使用一般信息问卷收集基线特征。在术前 1 天以及术后 2、4、12、24 和 48 周时进行饮水吞咽试验和吞咽生活质量问卷(SWAL-QOL)。

结果

术前 1 天有 1 例(1.5%)出现吞咽功能障碍,术后 2、4、12、24 和 48 周时分别有 49 例(72.1%)、44 例(64.7%)、33 例(49.3%)、19 例(28.4%)和 8 例(11.9%)出现吞咽功能障碍。术前 1 天 SWAL-QOL 总分平均为 4266.3±232.0,术后 2、4、12、24 和 48 周时分别为 1992.9±1062.4、2473.9±962.9、3169.2±753.6、3696.7±718.3 和 3910.8±1510.4。SWAL-QOL 总分术后逐渐升高,差异有统计学意义(P<0.05)。术后 24 和 48 周时差异无统计学意义(P=0.379)。

结论

喉部分切除术影响喉癌患者的吞咽功能和吞咽相关 QoL。虽然吞咽功能和吞咽相关 QoL 随时间逐渐改善,但在一些患者中,术后近 1 年仍未完全恢复。因此,术后护理应注意提高吞咽功能。

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本文引用的文献

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Laryngeal cancer incidence and mortality in China, 2010.2010年中国喉癌的发病率和死亡率
J Cancer Res Ther. 2015 Oct;11 Suppl 2:C143-8. doi: 10.4103/0973-1482.168175.
6
The multidimensional impact of total laryngectomy on women.全喉切除术对女性的多维度影响。
J Commun Disord. 2015 Jul-Aug;56:59-75. doi: 10.1016/j.jcomdis.2015.06.008. Epub 2015 Jul 2.
8
Is partial laryngectomy safe forever?部分喉切除术能永远安全吗?
Am J Otolaryngol. 2015 May-Jun;36(3):437-41. doi: 10.1016/j.amjoto.2014.11.005. Epub 2014 Nov 20.

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