基于营养评估吞咽功能康复训练及护理对下咽癌术后的康复效果  

Efficacy of swallowing rehabilitation training and nursing based on nutritional assessment for postoperative rehabilitation in hypopharyngeal cancer

作　　者：宋艳 郭琳燕 SONG Yan;GUO Lin-yan(Department of Rehabilitation,Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]陕西省空军军医大学第二附属医院康复科,西安710038

出　　处：《中国肿瘤临床与康复》2020年第12期1528-1532,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨基于营养评估的吞咽功能康复训练及护理对下咽癌术后的康复效果。方法选取2017年11月至2019年12月间空军军医大学第二附属医院收治的行下咽癌手术治疗的100例患者的诊疗情况进行回顾性分析。按照护理方法的不同将所有患者分为观察组与对照组。采用常规护理的50例患者纳入对照组,采用基于营养评估的吞咽功能康复训练及护理的50例患者纳入观察组。出院前比较两组患者各项临床指标、营养状况、吞咽功能情况、干预前后的生活质量以及并发症发生率。结果观察组患者的手术切口愈合时间、引流管拔出时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者的改良定量主观综合性营养评估量表(MQ-SGA)评分低于对照组患者,血清总蛋白(TP)、血清白蛋白(ALB)和前白蛋白(PAB)水平均高于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者的吞咽功能总异常率低于对照组患者,差异有统计学意义(P<0.05)。干预前观察组患者的语言被理解能力、饮食与社交场合下进食评分与对照组相比,差异无统计学意义(P>0.05)。干预后观察组患者的语言被理解能力、饮食与社交场合下进食评分均高于对照组患者,差异均有统计学意义(均P<0.05)。观察组患者并发症发生率低于对照组患者,差异有统计学意义(P<0.05)。结论基于营养评估的吞咽功能康复训练及护理,能够有效改善下咽癌患者术后的康复效果。Objective To study the efficacy of swallowing rehabilitation training and nursing based on nutritional assessment for postoperative rehabilitation in hypopharyngeal cancer.Methods The clinical data of 100 patients with hypopharyngeal carcinoma who received surgical treatment at Second Affiliated Hospital of Air Force Military Medical University from November 2017 to December 2019 were retrospectively analyzed.Based on the nursing they received,the patients were divided into an observation group and a control group.Fifty patients receiving rehabilitation training and nursing for swallowing function were included in the observation group and 50 patients receiving conventional nursing were included in the control group.Before discharge,the clinical indicators,nutritional status,swallowing function,quality of life and the incidence of complications were compared between the two groups.Results The incision healing time,time to extubation and length of hospital stay were significantly shorter in the study group than in the control group(all P<0.05).The scores of modified quantitative subjective global assessment(MQ-SGA)for nutritional status were significantly lower and the levels of serum total protein(TP),serum albumin(ALB),prealbumin(PAB)were significantly higher in the observation group than in the control group(all P<0.05).The overall rate of abnormal swallowing was significantly lower in the observation group than in the control group(P<0.05).Before the intervention,there was no significant difference in the language understanding ability,diet and eating scores in social occasions between the two groups(P>0.05).After the intervention,the language understanding ability,diet and social eating scores were significantly higher in the observation group than in the control group(all P<0.05).The incidence of complications was significantly lower in the observation group than in the control group(all P<0.05).Conclusion The rehabilitation training and nursing for swallowing function based on nutritional assessment can eff

关 键 词：咽喉肿瘤 术后康复 吞咽功能 营养评估 康复效果 并发症 

分 类 号：R739.63[医药卫生—肿瘤]