早期吞咽功能训练对老年鼻咽癌放疗患者吞咽功能的影响^*

The effect of early swallowing training on swallowing function in elderly patients with nasopharyngeal carcinoma receiving radiotherapy

摘要

目的 讨论早期吞咽功能训练对老年鼻咽癌放疗患者吞咽功能的影响。方法 选择2019年6月—2024年9月吉林大学中日联谊医院放疗科完成根治性放疗的51例老年鼻咽癌患者进行回顾性分析。根据是否接受吞咽功能训练分为训练组 (26例) 和对照组 (25例), 对照组接受健康教育及随访观察, 训练组在此基础上于放疗早期开始持续3~6个月的吞咽功能训练。比较两组在放疗后即刻与放疗后3个月的吞咽情况和营养状态。结果 在放疗后即刻和放疗后3个月, 训练组洼田饮水试验 (WST) 得分以及吞咽造影检查 (VFSS) 得分低于对照组, 安德森吞咽困难量表 (MDADI) 得分高于对照组, 差异均有统计学意义 (P<0.05); 放疗后3个月, 训练组的WST得分和VFSS得分显著低于放疗结束时, 差异均有统计学意义 (P<0.05); 而对照组的WST得分和VFSS得分与放疗结束时比较, 差异无统计学意义 (P>0.05); 训练组和对照组的MDADI量表得分高于放疗结束时, 差异均有统计学意义 (P<0.05)。在放疗后3个月, 训练组的患者主观整体评估量表得分低于对照组和放疗结束时 (P<0.05)。结论 老年鼻咽癌患者在放疗早期行吞咽功能训练可明显改善吞咽功能和营养状况。

Abstract

Objective To explore the influence of early swallowing training on the swallowing function of elderly patients with nasopharyngeal carcinoma receiving radiotherapy. Methods From June 2019 to September 2024, 51 elderly patients with nasopharyngeal carcinoma in the radiotherapy department of China-Japan Union hospital of Jilin University were analyzed retrospectively. They were divided into a training group (26 cases) and a control group (25 cases) according to whether they received swallowing function training. The control group received health education and follow-up observation, while the training group started swallowing function training for 3-6 months in the early stage of radiotherapy on this basis. The swallowing function and nutritional status of the two groups immediately after radiotherapy and 3 months after radiotherapy were analyzed and compared. Results Immediately after radiotherapy and 3 months after radiotherapy, the scores of water swallow test (WST) and videofluoroscopic swallowing study (VFSS) in the training group were lower than those in the control group, while the scores of M. D. Anderson dysphagia inventory (MDADI) was higher than that in the control group, the differences were statistically significant (P<0.05). Three months after radiotherapy, the scores of WST and VFSS of the training group were significantly lower than those at the end of radiotherapy, and the difference was statistically significant (P<0.05). However, there was no statistically significant difference in the scores of WST and VFSS of the control group compared with those at the end of radiotherapy (P>0.05). The MDADI scale scores of the training group and the control group were higher than those at the end of radiotherapy, the difference was statistically significant (P<0.05). Three months after radiotherapy, the score of the patient-generated subjective global assessment of the training group was lower than that in the control group and at the end of radiotherapy (P<0.05). Conclusion Swallowing training for elderly patients with nasopharyngeal carcinoma in the early stage of radiotherapy can significantly improve their swallowing function and nutritional status.

关键词

鼻咽癌 / 放疗 / 吞咽功能训练 / 营养状况

Key words

Nasopharyngeal carcinoma / Radiotherapy / Swallowing training / Nutritional status

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基金资助

^*吉林省自然科学基金(20200201432JC)