基于循证和德尔菲法构建喉部分切除术后患者分阶段吞咽训练方案  

A phased swallowing training program after partial laryngectomy

作　　者：汪璐璐 方俊[1] 徐文红 张标新[1] 刘业海[1] Wang Lulu;Fang Jun;Xu Wenhong;Zhang Biaoxin;Liu Yehai(Department of Otolaryngology Head and Neck Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科,合肥230022

出　　处：《中华物理医学与康复杂志》2023年第8期726-730,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：2019年度国家自然科学基金院内青年培育计划项目(2019kj23);2015年安徽省科技攻关项目(1501041147);安徽医科大学第一附属医院首批"登峰计划"学科建设项目(院科[2019]22号)。

摘　　要：目的基于循证和德尔菲法构建喉部分切除术后患者分阶段吞咽训练方案。方法基于循证原则系统筛选最佳证据,拟定喉部分切除术后患者分阶段吞咽训练方案初稿,进行2轮德尔菲专家函询,对推荐证据与意见实施论证与修订后形成终稿。结果最终确立了包括胃肠减压期、持续管饲期第一阶段、持续管饲期第二阶段、间歇管饲期试进食阶段、经口进食期5个阶段共27个条目的喉部分切除术后患者分阶段吞咽训练方案。2轮专家函询问卷有效回收率均为100%,专家权威系数分别为0.842、0.861,Kendall协调系数分别为0.261(χ2=54.232,P<0.001)、0.427(χ2=72.175,P<0.001)。结论本研究构建的喉部分切除术后患者分阶段吞咽训练方案具有科学性和临床适用性,可为临床医护人员改善吞咽管理实践提供参考。Objective To construct an evidence-based phased swallowing training program for patients after partial laryngectomy applying the Delphi method.Methods Evidence was screened systematically applying evi-dence-basing principles to construct a first draft of a phased swallowing training program for patients after partial lar-yngectomy.After two rounds of Delphi expert consultation a final draft was formed.Results The protocol was com-posed of 27 items covering 5 aspects of the gastrointestinal decompression period,the first-and second-stage continu-ous tube feeding periods,trial feeding of the intermittent tube feeding period and the oral feeding stage.Conclusion The phased swallowing training program is scientifically sound and feasible in clinical practice.It can provide refer-ences for clinic staff to improve swallowing management.

关 键 词：喉部分切除术 分阶段 吞咽训练 循证 德尔菲 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]