舌压抗阻反馈训练在甲状腺癌根治术后吞咽功能障碍患者中的应用效果  

Efficacy of tongue pressure resistance training in patients with swallowing disorders after radical resection for thyroid cancer

作　　者：孙飞 张杰[2] SUN Fei;ZHANG Jie(Department of Head and Neck Surgery,Shaanxi Cancer Hospital,Xi’an 710061,China;Department of Nursing,Jintai Hospital,Baoji 721001,China)

机构地区：[1]陕西省肿瘤医院头颈外科,西安710061 [2]宝鸡市金台医院护理部,宝鸡721001

出　　处：《中国肿瘤临床与康复》2021年第12期1440-1443,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨舌压抗阻反馈训练在甲状腺癌根治术后吞咽功能障碍患者中的应用效果。方法选取2018年9月至2020年7月间陕西省肿瘤医院收治的98例甲状腺癌根治术后吞咽功能障碍患者,采用随机信封抽签原则分为观察组和对照组,每组49例。对照组患者采用常规治疗,观察组患者在常规治疗基础上联合舌压抗阻反馈训练,比较两组患者吞咽功能、治疗效果及并发症发生情况。结果两组患者治疗期间均发生吸入性肺炎、呛咳、噎食和窒息等并发症,观察组患者发生率为4.1%,低于对照组的26.5%,差异有统计学意义(P <0.05)。治疗后,两组患者洼田饮水试验评分均较治疗前降低,藤岛一郎吞咽障碍评分均升高,且两组比较,差异均有统计学意义(均P <0.05)。治疗后,观察组患者质量总有效率为98.0%,高于对照组的83.7%,差异有统计学意义(P <0.05)。两组患者平均随访时间为(11.42±1.22)个月,观察组患者复发率为2.0%(1例),低于对照组的12.2%(6例),差异有统计学意义(P <0.05)。结论甲状腺癌根治术后吞咽功能障碍患者采用舌压抗阻反馈训练,可改善临床症状,降低并发症发生,提高治疗效果,降低复发率。Objective To explore the efficacy of tongue pressure resistance training in patients with trouble swallowing after radical surgery for thyroid cancer. Methods From September 2018 to July 2020,98 patients with difficult swallowing after radical resection for thyroid cancer were selected at Shaanxi Cancer Hospital. They were divided into an observation group and a control group with 49 patients in each group using the principle of random envelope drawing. The observation group received tongue pressure resistance training besides conventional treatment and the control group were given conventional treatment. The swallowing function,treatment efficacy and incidence of complications were compared between the two groups.Results The incidence of complications such as aspiration pneumonia,choking and asphyxia during treatment was 4. 1% in the observation group,which were lower than 26. 5% of the control group( P < 0. 05).The scores of the Kubota Water swallow test decreased after treatment in the two groups compared with those before the treatment and Fujishima Ichiro’s dysphagia score were increased in the two groups compared with those before treatment,and the difference between the two groups was statistically significant( all P <0. 05). The overall efficacy rate was 98. 0% in the observation group which were higher than 83. 7% of the control group( P < 0. 05). All patients were followed up after treatment for an average time of 11. 42 ± 1. 22 months. The recurrence rates was 2. 0%( 1 pateint) in the observation group,which is lower than 12. 2%( 6 patients) of control group( P < 0. 05). Conclusion Tongue pressure resistance training can relieve clinical symptoms,reduce the incidence of complications,improve therapeutic efficacy and reduce the recurrence rate in patients with dysphagia after radical resection for thyroid cancer.

关 键 词：舌压抗阻反馈训练 甲状腺癌根治术 吞咽功能障碍 洼田饮水试验 

分 类 号：R736.1[医药卫生—肿瘤]