舌压抗阻反馈训练结合吞咽训练对头颈部肿瘤放疗后吞咽障碍患者的疗效观察  

Efficacy of tongue pressure resistance feedback training combined with swallowing training on swallowing function in patients with head and neck cancer after radiotherapy

作　　者：林祖琛 徐乐义[1] 周雪珍[1] 卓飞男 林静静[1] 冯常武[2] Lin Zuchen;Xu Leyi;Zhou Xuezhen(Department of Rehabilitation Medicine,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院康复医学科,浙江温州325000 [2]黄石市中心医院康复医学科,湖北黄石435000

出　　处：《中国康复》2025年第1期16-20,共5页Chinese Journal of Rehabilitation

基　　金：温州市基础性科研项目(Y20211134)。

摘　　要：目的:探讨舌压抗阻反馈训练结合吞咽训练对头颈部肿瘤放疗后吞咽障碍患者的治疗效果。方法:将温州医科大学附属第一医院康复医学科收治的头颈部肿瘤放疗后吞咽障碍患者60例,随机分为对照组和观察组,每组30例。对照组予以常规吞咽训练,观察组在常规吞咽训练的基础上进行舌压抗阻反馈训练,每周5次,共持续8周。在治疗前、治疗4周后及8周后分别评估2组患者治疗前后的功能性经口摄食等级(FOIS)、吞咽造影检查评分(VFSS)、Rosenbek渗透-误吸量表评分(PAS)。结果:治疗前,2组患者VFSS和PAS评分、FOIS评级差异均无统计学意义;治疗4周、8周后,2组患者FOIS评级、VFSS评分均较治疗前显著提高(P<0.05),PAS评分降低(P<0.05)。治疗4周后,观察组VFSS评分较对照组提高(P<0.05),PAS评分较对照组降低(P<0.05)。治疗8周后,观察组FOIS评级、VFSS评分均较对照组提高(P<0.05),PAS评分较对照组降低(P<0.05)。2组VFSS评分在时间、组别、交互效应上差异均具有统计学意义(P<0.05),PAS评分在组别、时间效应上差异具有统计学意义(P<0.05),FOIS等级在时间效应和交互效应上差异具有统计学意义(P<0.05)。结论:舌压抗阻反馈训练结合吞咽训练在改善头颈部肿瘤放疗后吞咽障碍患者的吞咽功能和降低误吸风险方面起着积极作用。Objective:To explore the efficacy of tongue pressure resistance feedback training on aspiration in patients with swallowing disorders after radiotherapy for head and neck cancer(HNC).Methods:Totally,60 patients with HNC admitted to our rehabilitation department from September 2023 to March 2024 were randomly divided into a control group and an observation group,with 30 cases in each group.The control group received conventional swallowing therapy,and the observation group received tongue pressure resistance feedback training in addition to conventional treatment.Functional oral intake scale(FOIS),video fluoroscopic swallowing study(VFSS),and Rosenbek penetration-aspiration scale(PAS)were assessed before and after treatment for both groups.Results:There were no statistically significant differences in FOIS level,VFSS,and PAS scores between the two groups before treatment.After 4 and 8 weeks of treatment,the FOIS tevel and VFSS scores of the patients in both groups increased(P<0.05)and the PAS scores decreased(P<0.05).After 8 weeks of treatment,the observation group showed significant improvement in FOIS level,VFSS,and PAS scores compared to the control group(P<0.05).The FOIS level varied over time,with no significant difference between the training methods,but it was possible that the training methods may have altered its trend of change.Both VFSS scores and PAS scores were influenced by both the training methods and the duration of treatment(P<0.05).Conclusion:Tongue pressure resistance feedback training combined with swallowing training plays a positive role in improving swallowing function and reducing aspiration risk in patients with HNC.

关 键 词：头颈部肿瘤 舌压抗阻反馈训练 吞咽训练 吞咽功能 

分 类 号：R49[医药卫生—康复医学] R73[医药卫生—临床医学]