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吞咽训练联合营养干预对手术联合放疗后吞咽困难的喉癌患者营养状况及生活质量的影响。

Effect of swallowing training combined with nutritional intervention on the nutritional status and quality of life of laryngeal cancer patients with dysphagia after operation and radiotherapy.

机构信息

Department of Otolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

Department of Lymph and Vascular Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

出版信息

J Oral Rehabil. 2022 Jul;49(7):729-733. doi: 10.1111/joor.13328. Epub 2022 Apr 18.

DOI:10.1111/joor.13328
PMID:35352383
Abstract

BACKGROUND

Dysphagia is a common complication in patients with laryngeal cancer after surgery and radiotherapy.

OBJECTIVES

To explore the effect of swallowing training administered in combination with nutritional intervention on the nutritional status and quality of life of laryngeal cancer patients with dysphagia after surgery and radiotherapy.

METHODS

Sixty-six patients with laryngeal cancer who developed dysphagia were randomly divided into control group and intervention group (n = 33 in each group). Patients in both groups received total laryngectomy and prophylactic radiotherapy and were provided routine health counseling and swallowing training. Patients in the intervention group were additionally provided with nutritional intervention. All patients were evaluated using video fluoroscopic swallowing examination (VFSE), Patient-Generated Subjective Global Assessment on nutritional status (PG-SGA) score, and Quality of Life Questionnaire-core 30 (QLQ-c30) score immediately after radiotherapy and 3 months later.

RESULTS

Prior to swallowing training, there was no significant between-group difference with respect to VFSE evaluation, PG-SGA score, or QLQ-c30 score. Both groups showed improvement in these measures at 3 months after radiotherapy; however, the improvement in the intervention group was significantly better than that in the control group.

CONCLUSIONS

Swallowing training combined with nutritional intervention can improve swallowing function, nutritional status and the quality of life of laryngeal cancer patients with dysphagia after operation and radiotherapy.

摘要

背景

吞咽困难是喉癌患者手术后和放疗后的常见并发症。

目的

探讨吞咽训练联合营养干预对喉癌术后放疗后吞咽困难患者营养状况和生活质量的影响。

方法

将 66 例喉癌术后吞咽困难患者随机分为对照组和干预组(每组 33 例)。两组患者均行全喉切除术和预防性放疗,并给予常规健康咨询和吞咽训练。干预组患者还进行了营养干预。所有患者均在放疗后即刻和 3 个月后进行视频透视吞咽检查(VFSE)、患者生成的主观整体评估营养状况(PG-SGA)评分和生活质量问卷核心 30(QLQ-c30)评分。

结果

在进行吞咽训练之前,VFSE 评估、PG-SGA 评分和 QLQ-c30 评分两组间无显著差异。两组在放疗后 3 个月时均有改善,但干预组的改善明显优于对照组。

结论

吞咽训练联合营养干预可改善喉癌术后放疗后吞咽困难患者的吞咽功能、营养状况和生活质量。

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