不同术式对喉癌患者早期吞咽功能的影响  

Effect of different operation methods on early swallowing function of patients with laryngeal cancer

作　　者：龙海欣[1] 南方[1] 田梓蓉[2] 李秀雅[1] 刘永玲[1] 陈晓红[1] LONG Haixin;NAN Fang;TIAN Zirong;LI Xiuya;LIU Yongling;CHEN Xiaohong(Department of Otolaryngology Head and Neck Surgery;Department of Nursing,Affiliated 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：《重庆医学》2024年第22期3407-3411,共5页Chongqing Medical Journal

基　　金：首都医科大学附属北京同仁医院院内基金项目(2020-YJJ-HLL-003);北京市医院管理中心2021年度“培育计划”(PX2021008);首都医科大学2023年度数智护理基础临床协同研究专项立项课题(SZHL23M04)。

摘　　要：目的评估不同术式对喉癌患者早期吞咽功能的影响。方法采用便利抽样法选取2021-2022年在该院行首次开放性喉切除手术的138例喉癌患者为研究对象,根据手术方式分为喉垂直部分切除组(垂直组,n=34)、喉水平部分切除组(水平组,n=26)、环状软骨上喉部分切除-环舌骨会厌固定组(SCPL-CHEP组,n=26)、全喉切除组(全喉组,n=52)。患者术后经口进食第1天采用中文版安德森吞咽困难量表、悉尼吞咽问卷、改良洼田饮水试验等评估吞咽功能。结果各组中文版安德森吞咽困难量表总分及各维度得分、悉尼吞咽问卷总分及各维度得分、改良洼田饮水试验结果比较差异有统计学意义(P<0.01);全喉组上述指标与其他组比较差异有统计学意义(P<0.01),但水平组、垂直组及SCPL-CHEP组上述指标两两组间比较差异无统计学意义(P>0.05)。结论行开放性喉切除手术的喉癌患者中全喉切除术后早期进食时吞咽障碍较轻,对生活影响较小。Objective To evaluate the effect of different operation methods on the early swallowing function in the patients with laryngocarcinoma.Methods A total of 138 patients with the first time of open laryngectomy in this hospital from January 2021 to December 2022 were selected as the research subjects by convenience sampling method.The patients were divided into the vertical laryngeal resection group(vertical group,n=34),horizontal laryngeal partial resection(horizontal group,26 cases),suprachloroid laryngeal partial resection annular hyoid epiglottis fixation group(SCPL-CHEP group,n=26)and total laryngeal resection group(total laryngeal group,n=52)according to the operation methods.The Anderson Dysphagia Scale,Sydney Dysphagia Scale and modified swale drinking water test were used to evaluate the swallowing function on the first day of postoperative oral feeding in the patients.Results The total scores and scores of various dimensions of the Chinese version of Anderson Dysphagia Scale,total scores and scores of various dimensions of Sydney Swallowing Scale and the results of the modified swale drinking water test had statistical differences among the various groups(P<0.01);the above indexes had statistical difference between the total laryngeal group and the other groups(P<0.01),but the above indexes had no statistical difference between the two groups in the horizontal group,vertical group and SCPL-CHEP group(P>0.05).Conclusion In the patients with laryngeal cancer undergoing open laryngectomy,the dysphagia is less severe during early eating after total laryngectomy,which has little impact on life.

关 键 词：喉切除术 吞咽功能 调查分析 喉癌 手术方式 

分 类 号：R762[医药卫生—耳鼻咽喉科]