个性化吞咽康复在口腔癌游离皮瓣移植后患者中的应用  

Personalized swallowing rehabilitation patients with oral cancer after free flap transplantation

作　　者：章爱丽 刘小娜 刘江炎 毛妍 ZHANG Aili;LIU Xiaona;LIU Jiangyan;MAO Yan(Surgery for Oral,Maxillofacial,Head and Neck Tumors,Nanjing Stomatology Hospital,Medicine School of Nanjing University,Nanjing,Jiangsu 210008,China;不详)

机构地区：[1]南京大学医学院附属口腔医院口腔颌面头颈肿瘤外科,江苏南京210008 [2]南京大学医学院附属口腔医院大外科,江苏南京210008

出　　处：《中国临床研究》2023年第12期1905-1909,共5页Chinese Journal of Clinical Research

基　　金：江苏省“六个一工程”拔尖人才科研项目(LGY201911)。

摘　　要：目的探讨口腔癌游离皮瓣移植(OC-FFT)后个性化吞咽康复的干预效果。方法选择2022年1月至12月南京市口腔医院进行OC-FFT治疗的88例口腔癌患者为研究对象。根据随机数字表法分为对照组和干预组,每组44例。对照组给予常规护理干预,干预组在常规护理基础上进行每天2次,持续10 d的个性化吞咽康复训练,采用吞咽能力评估量表(MASA-OC)、体重下降百分比、营养指标(前白蛋白、白蛋白、血红蛋白)、胃管拔除时间、生活质量量表(UW-QOLv4)评估干预效果。结果与对照组患者相比,干预组术后7 d、14 d、1个月3个时间点的MASA-OC评分和体重下降百分比情况均优于对照组(P<0.05)。术后,干预组患者营养指标情况、胃管拔除时间以及生活质量也优于对照组,比较差异具有统计学意义(P<0.05)。结论个性化吞咽康复能提高OC-FFT患者吞咽功能,帮助患者尽早拔除鼻胃管恢复经口进食,改善其营养状况和生活质量。Objective To investigate the intervention effect of personalized swallowing rehabilitation in patients with oral cancer after free flap transplantation(OC-FFT).Methods From January to December 2022,88 patients who received OC-FFT in Nanjing Stomatology Hospital were selected as the research objects.And they were divided into control group and intervention group randomly(n=44,each).The routine nursing intervention was conducted in control group,while personalized swallowing rehabilitation combined with routine nursing intervention was conducted in intervention group(twice a day,continued for 10 days).Mann Assessment of Swallowing Ability-Oral Cancer(MASA-OC),percentage of weight loss,nutritional indicators(prealbumin,albumin,hemoglobin),gastric tube removal time,and quality of life scale(University of Washington Quality of Life Questionnaire version 4,UW-QOLv4)were used to evaluate the intervention effect.Results Compared with patients in the control group,the MASA-OC score and percentage of body weight loss at 7 days,14 days,and 1 month after operation were better than those in the control group(P<0.05).And postoperatively,the nutritional indicators,gastric tube removal time,and quality of life of the intervention group were better than those of the control group(P<0.05).Conclusion Personalized swallowing rehabilitation can improve the swallowing function of patients with OC-FFT,help patients remove nasogastric tube as soon as possible to resume oral feeding,and improve their nutritional status and quality of life.

关 键 词：口腔癌 个性化吞咽康复 游离皮瓣移植 营养状况 生活质量 吞咽能力 胃管拔除时间 

分 类 号：R473.78[医药卫生—护理学]