吞咽训练对头颈肿瘤放疗后患者吞咽功能及生活质量影响的Meta分析  

Effect of swallowing training on swallowing function and quality of life in patients with head and neck cancer after radiotherapy:a Meta-analysis

作　　者：任晓波[1] 南方[1] 田梓蓉[2] 李飞[2] Ren Xiaobo;Nan Fang;Tian Zirong;Li Fei(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Nursing,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]首都医科大学附属北京同仁医院护理部,北京100730

出　　处：《中华现代护理杂志》2022年第29期4038-4045,共8页Chinese Journal of Modern Nursing

基　　金：北京市医院管理中心"培育计划"(PX2021009);首都医科大学附属北京同仁医院科研基金(2020-YJJ-HLL-003)。

摘　　要：目的:评价吞咽训练对头颈肿瘤放疗后患者吞咽功能及生活质量的影响。方法:计算机检索Cochrane Library、CINAHL、PubMed、Embase、Web of Sience、Sinomed、中国知网、万方、维普数据库中的与吞咽训练对头颈肿瘤放疗后患者吞咽功能及生活质量影响相关的随机对照试验研究,文献发表时间为从建库至2021年12月10日。由本文前2名作者独立进行文献筛选,采用Cochrane质量评价手册5.1.0推荐的偏倚风险评价工具对文献方法学质量进行评价,采用RevMan 5.3软件对吞咽功能和生活质量的相关指标进行数据分析。结果:最终纳入12篇文献,共计701例患者。吞咽训练对头颈肿瘤放疗后患者吞咽功能影响的Meta分析结果显示,头颈肿瘤放疗后患者经过吞咽训练可以有效改善吞咽功能:洼田饮水试验(RR=1.82,95%CI:1.51~2.19,P<0.00001)、电视透视吞咽功能检查(RR=1.91,95%CI:1.34~2.72,P=0.0004)、标准吞咽功能评估表(MD=-6.47,95%CI:-8.42~-4.52,P<0.00001)、功能性经口摄食量表(MD=1.50,95%CI:1.16~1.84,P<0.00001)。吞咽训练对头颈肿瘤放疗后患者生活质量影响的Meta分析结果显示,研究间存在异质性且异质性较高。结论:头颈肿瘤放疗后患者经过吞咽训练可以有效改善吞咽功能,但是生活质量是否提高还需要更多证据进一步证实。Objective To evaluate the effect of swallowing training on swallowing function and quality of life in patients with head and neck cancer after radiotherapy.Methods Cochrane Library,CINAHL,PubMed,Embase,Web of Science,Sinomed,CNKI,Wanfang and VIP databases were searched by computer for randomized controlled trials related to effects of swallowing training on swallowing function and quality of life of patients with head and neck cancer after radiotherapy.The publication time of the literatures was from the establishment of the database to December 10,2021.The first two authors of this article independently screened the literature,and the methodological quality of the literature was evaluated using the risk of bias assessment tool recommended by the Cochrane Quality Evaluation Manual 5.1.0.RevMan 5.3 software was used for data analysis of related indicators of swallowing function and quality of life.Results Finally,12 articles with a total of 701 patients were included.Meta-analysis of the effect of swallowing training on the swallowing function of patients with head and neck tumors after radiotherapy showed that swallowing training in patients with head and neck tumors after radiotherapy can effectively improve swallowing function:Kubota Water Swallowing Test(RR=1.82,95%CI:1.51-2.19,P<0.00001),Videofluoroscopic Swallowing Study(RR=1.91,95%CI:1.34-2.72,P=0.0004),Standardized Swallowing Assessment(MD=-6.47,95%CI:-8.42--4.52,P<0.00001),Functional Oral Intake Scale(MD=1.50,95%CI:1.16-1.84,P<0.00001).Meta-analysis of the effect of swallowing training on the quality of life of patients with head and neck cancer after radiotherapy showed that there was heterogeneity among studies and the heterogeneity was high.Conclusions Swallowing training can effectively improve the swallowing function of patients with head and neck cancer after radiotherapy,but whether the quality of life is improved still needs more evidence to further confirm.

关 键 词：头颈部肿瘤 吞咽训练 吞咽功能 放疗 生活质量 META分析 

分 类 号：R473.73[医药卫生—护理学]