Ding Zhen, Zhou Lingmei, Jin Kemei, Wu Runjinxing, Gui Yihua
Clinical Nutrition Department, Ningbo Medical Center Li Huili Hospital, Ningbo, China.
Department of Otolaryngology, Head and Neck Surgery, Ningbo Medical Center Li Huili Hospital, Ningbo, China.
Front Nutr. 2023 Oct 5;10:1239911. doi: 10.3389/fnut.2023.1239911. eCollection 2023.
Tongue cancer is one of the common malignancy of the head and neck, and directly impacts chewing, swallowing, and other eating activities. Based on the evidence-based guidelines and clinical management, this paper presents nutrition management experience of a patient with tongue cancer who had a dysphagia and feeding reflux while undergoing radiotherapy and chemotherapy.
Nutritional risk screening and comprehensive nutritional assessment were performed based on the patient's medical history, and personalized nutritional programs were developed under the guidance of the clinical pharmaceutical consensus of parenteral nutrition and nutritional treatment guidelines for patients with tumors during radiotherapy. For the management of oral feeding, the patient's swallowing function was evaluated to manage oral feeding. Thickening powders were used to improve the consistency of the patient's food, which successfully achieved oral feeding of the patient.
The patient finally ate five meals a day by mouth, and energy requirements were met using industrialized nutritional supplements, and homogenized food was added in between the meals. The energy provided by enteral nutrition can reached approximately 60-75%. The patient's weight and albumin levels had increased significantly at the time of discharge.
The nutritional management of patients with dysphagia should be jointly managed by clinicians, nurses, nutritionists, and family members to effectively improve the quality of life (QOL) and nutritional status of patients. To ensure adequate nutritional supply, appropriate swallowing training may delay the deterioration of the chewing function and improve the eating experience of such patients.
舌癌是头颈部常见的恶性肿瘤之一，直接影响咀嚼、吞咽及其他进食活动。基于循证指南和临床管理，本文介绍了一名舌癌患者在放化疗期间出现吞咽困难和进食反流时的营养管理经验。
根据患者病史进行营养风险筛查和综合营养评估，并在肠外营养临床药学共识和肿瘤患者放疗期间营养治疗指南的指导下制定个性化营养方案。对于经口进食管理，评估患者吞咽功能以管理经口进食。使用增稠粉改善患者食物的黏稠度，成功实现了患者的经口进食。
患者最终每天经口进食5餐，通过工业化营养补充剂满足能量需求，并在两餐之间添加匀浆食物。肠内营养提供的能量可达约60-75%。出院时患者体重和白蛋白水平显著增加。
吞咽困难患者的营养管理应由临床医生、护士、营养师和家庭成员共同管理，以有效改善患者的生活质量（QOL）和营养状况。为确保充足的营养供应，适当的吞咽训练可能会延缓咀嚼功能的恶化，并改善此类患者的进食体验。
