下颏抗阻力训练联合营养支持改善鼻咽癌放疗后患者吞咽功能和营养状态的作用  

Effect of chin tuck against resistance combined with nutritional support on improving swallowing function and nutritional status of patients with nasopharyngeal carcinoma after radiotherapy

作　　者：胡优露 李小燕[1] 郑立荣[1,2] 梁小平 杨洁[1] HU Youlu;LI Xiaoyan;ZHENG Lirong;LIANG Xiaoping;YANG Jie(Department of Otorhinolaryngology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Linhai 317000,China;Department of Otorhinolaryngology,Taizhou Enze Medical Center(Group)Enze Hospital,Taizhou 318050,China;Department of Rehabilitation,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Linhai 317000,China)

机构地区：[1]浙江省台州医院耳鼻咽喉科,浙江临海317000 [2]浙江省台州恩泽医疗中心(集团)恩泽医院耳鼻咽喉科,浙江台州318050 [3]浙江省台州医院康复科,浙江临海317000

出　　处：《中国现代医生》2022年第3期71-74,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2019KY245)。

摘　　要：目的探讨下颏抗阻力(CTAR)训练联合营养支持改善鼻咽癌(NPC)放疗后患者吞咽功能和营养状态的作用。方法选取2018年1月至2020年6月浙江省台州医院、浙江省台州恩泽医疗中心(集团)恩泽医院耳鼻咽喉科门诊就诊NPC放疗后吞咽障碍患者72例,随机分为干预组和对照组各36例。两组患者均营养支持基础治疗,对照组患者在此基础上予常规吞咽训练,干预组患者在此基础上予CTAR训练,两组患者均连续干预8周。评估两组患者干预前后经口进食、吞咽功能及营养状况情况。结果干预8周后,对照组和干预组患者FOIS评分[(3.08±0.57)分、(3.69±0.59)分]和MDADI评分[(62.15±10.22)分、(67.15±11.24)分]较干预前[(2.45±0.44)分、(2.39±0.41)分、(55.17±9.07)分、(54.74±8.79)分]明显上升(P<0.05),且干预组患者上升幅度更显著(P<0.05);对照组和干预组患者血清Hb[(113.05±15.14)g/L、(120.04±16.02)g/L]和ALB[(31.15±3.03)g/L、(34.52±3.12)g/L]水平及MAMC[(23.56±3.12)cm、(26.27±3.45)cm]较干预前[(99.15±14.07)g/L、(98.92±13.78)g/L、(28.17±2.97)g/L、(28.21±2.87)g/L、(20.12±2.78)cm、(20.09±2.84)cm]显著上升(P<0.05),且干预组患者上升幅度更显著(P<0.05)。结论CTAR训练联合营养支持不仅能明显改善NPC放疗后患者经口进食及吞咽功能,而且可明显提升患者营养状况。Objective To investigate the effect of chin tuck against resistance(CTAR)combined with nutritional support on improving swallowing function and nutritional status of patients with nasopharyngeal carcinoma(NPC)after radiotherapy.Methods From January 2018 to June 2020,72 patients with dysphagia after radiotherapy for NPC who visited our otorhinolaryngology clinic were randomly divided into intervention group(n=36)and control group(n=36).The patients in the two groups were given the basic treatment of nutritional support.The control group was given conventional swallowing training on this basis,and the intervention group was given CTAR training.The two groups were continuously intervened for eight weeks.Oral intake,swallowing function,and nutritional status was assessed before and after intervention in both groups.Results After 8 weeks of intervention,the FOIS score[(3.08±0.57)points,(3.69±0.59)points]and MDADI score[(62.15±10.22)points,(67.15±11.24)points]in the control group and intervention group were significantly higher than those before intervention[(2.45±0.44)points,(2.39±0.41)points,(55.17±9.07)points,(54.74±8.79)points],and the difference was statistically significant(P<0.05).The increase in the intervention group was more significant than that in the control group,and the difference between the two groups was statistically significant(P<0.05).The serum Hb[(113.05±15.14)g/L,(120.04±16.02)g/L],ALB[(31.15±3.03)g/L,(34.52±3.12)g/L]levels and MAMC[(23.56±3.12)cm,(26.27±3.45)cm]in the control group and intervention group were significantly higher than those before intervention[(99.15±14.07)g/L,(98.92±13.78)g/L,(28.17±2.97)g/L,(28.21±2.87)g/L,(20.12±2.78)cm,(20.09±2.84)cm],and the difference had statistical significance(P<0.05).The increase in the intervention group was more significant than that in the control group,with a statistically significant difference(P<0.05).Conclusion CTAR training combined with nutritional support can not only improve the oral intake and swallowing function of NPC

关 键 词：鼻咽癌 放疗 吞咽障碍 营养支持 下颏抗阻力训练 吞咽功能 营养状态 

分 类 号：R473.7[医药卫生—护理学]