Lee Hye Kyoung, Hwang Jihye, Jo Seongmoon, Kim Jin Kyong, Lee Cho Rok, Kang Sang-Wook, Nam Kee-Hyun, Cho Sung-Rae
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Graduate Program of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea.
Clin Med Insights Oncol. 2024 Nov 5;18:11795549241271715. doi: 10.1177/11795549241271715. eCollection 2024.
Antiadhesion products are essential for postoperative care in patients after thyroidectomy by providing a physical barrier to cover the exposed tissue and thus preventing abnormal adhesion of adjacent tissues. Since thyroidectomy may result in swallowing difficulties arising from damage or inflammation of the surrounding tissues, the use of antiadhesion agents such as MegaShield or Guardix-SG will help reduce scar formation. This may thus improve postoperative swallowing function in patients.
Patients were enrolled and followed up between October 4, 2018, and March 26, 2020. Patients during the postoperative follow-up sessions were randomly allocated to the standard care with Guardix-SG and clinical trial medical device application group with MegaShield (test group) in a 1:1 ratio by the permuted block randomization method. Patient performance on penetration aspiration scale (PAS), National Institutes of Health-Swallow Safety Scale (NIH-SSS), videofluoroscopic dysphagia scale (VDS), Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) based on Videofluoroscopic swallowing study (VFSS) were collected. Nonadhesion-reducing agent patient data were used as a control group.
No statistical significance was shown ( > .05) between the 2 groups of MegaShield and Guardix-SG in various phases from thick semisolid, thin semisolid to liquid for both PAS and NIH-SSS. Several statistical significances were reported in the results comparing various criteria of PAS, NIH-SSS, VDS at different oral and pharyngeal phases, and DIGEST in all 3 stages among MegaShield, Guardix-SG, and nonadhesion-reducing agent group.
These results prove the noninferiority of MegaShield compared with Guardix-SG as an antiadhesion agent in postthyroidectomy care.
抗粘连产品对于甲状腺切除术后患者的术后护理至关重要,它通过提供物理屏障覆盖暴露的组织,从而防止相邻组织异常粘连。由于甲状腺切除术可能因周围组织的损伤或炎症导致吞咽困难,使用诸如MegaShield或Guardix - SG等抗粘连剂有助于减少瘢痕形成。这进而可能改善患者的术后吞咽功能。
在2018年10月4日至2020年3月26日期间招募并随访患者。术后随访期间的患者通过置换区组随机化方法以1:1的比例随机分配到使用Guardix - SG的标准护理组和使用MegaShield的临床试验医疗器械应用组(试验组)。收集基于视频荧光吞咽造影研究(VFSS)的患者在渗透误吸量表(PAS)、美国国立卫生研究院吞咽安全量表(NIH - SSS)、视频荧光吞咽困难量表(VDS)、吞咽毒性动态成像分级(DIGEST)方面的表现。未使用减少粘连剂的患者数据用作对照组。
对于PAS和NIH - SSS,MegaShield组和Guardix - SG组在从浓稠半固体、稀薄半固体到液体的各个阶段均未显示出统计学意义(>0.05)。在比较MegaShield组、Guardix - SG组和未使用减少粘连剂组在不同口腔和咽部阶段的PAS、NIH - SSS、VDS的各种标准以及所有三个阶段的DIGEST的结果中,报告了若干统计学意义。
这些结果证明,在甲状腺切除术后护理中,作为抗粘连剂,MegaShield与Guardix - SG相比具有非劣效性。