早期康复训练对游离皮瓣修复舌癌术后语言功能、吞咽功能及生存质量的影响
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摘要
目的探讨早期康复训练对游离皮瓣修复舌癌术后语言功能、吞咽功能及生存质量的影响。方法选取2015年8月至2016年8月在该院治疗的舌癌患者25例为对照组,给予常规康复训练指导和宣教;另选取2016年9月至2017年10月在该院治疗的舌癌患者34例为观察组,在对照组的基础上给予早期康复训练。分析两组患者治疗前后语言功能、吞咽功能及生存质量的变化情况。结果治疗前,两组患者吞咽功能评分、语音清晰度及生存质量评分比较,差异均无统计学意义(P>0.05);术后2周、2个月与4个月,两组患者的语音清晰度及生存质量评分均低于治疗前(P<0.05),且术后2、4个月观察组患者语音清晰度及生存质量评分明显高于对照组(P<0.05);术后2周、2个月,两组患者的吞咽功能评分均高于治疗前(P<0.05),且术后2周观察组患者的吞咽功能评分明显低于对照组(P<0.05)。结论早期康复功能训练有助于改善游离皮瓣修复舌癌术后患者的语言功能、吞咽功能,提高患者的生存质量。
Objective To explore the effect of early rehabilitation training on the language function,swallowing function and quality of life in patients with tongue cancer after free flap repair.Methods A total of 25 patients with tongue cancer in this hospital from August 2015 to August 2016 were selected as the control group,and treated with regular rehabilitation training guidance and mission;other 34 patients with tongue cancer in this hospital from September 2016 to October 2017 were selected as the observation group,and treated with the early rehabilitation training on the basis of treatment received by the patients in the control group.The changes of language function,swallowing function and quality of life before and after treatment were analyzed.Results Before treatment,no statistically significant difference was found in the swallow function score,speech intelligibility and quality of life score between the two groups(P>0.05).Two weeks,2 months and 4 months after surgery,the speech intelligibility and quality of life scores of the two groups were significantly lower than those before treatment(P<0.05),and the speech intelligibility and quality of life scores in the observation group were significantly higher than those in the control group at 2 and 4 months after surgery(P<0.05).Two weeks and 2 months after surgery,the swallowing function scores of the two groups were significantly higher than those before treatment(P<0.05).The swallowing function score in the observation group was lower than that of the control group 2 weeks after surgery(P<0.05).Conclusion Early rehabilitation function training can improve the language function,swallowing function and the quality of life of patients with tongue cancer after free flap repair.
Objective To explore the effect of early rehabilitation training on the language function,swallowing function and quality of life in patients with tongue cancer after free flap repair.Methods A total of 25 patients with tongue cancer in this hospital from August 2015 to August 2016 were selected as the control group,and treated with regular rehabilitation training guidance and mission;other 34 patients with tongue cancer in this hospital from September 2016 to October 2017 were selected as the observation group,and treated with the early rehabilitation training on the basis of treatment received by the patients in the control group.The changes of language function,swallowing function and quality of life before and after treatment were analyzed.Results Before treatment,no statistically significant difference was found in the swallow function score,speech intelligibility and quality of life score between the two groups(P>0.05).Two weeks,2 months and 4 months after surgery,the speech intelligibility and quality of life scores of the two groups were significantly lower than those before treatment(P<0.05),and the speech intelligibility and quality of life scores in the observation group were significantly higher than those in the control group at 2 and 4 months after surgery(P<0.05).Two weeks and 2 months after surgery,the swallowing function scores of the two groups were significantly higher than those before treatment(P<0.05).The swallowing function score in the observation group was lower than that of the control group 2 weeks after surgery(P<0.05).Conclusion Early rehabilitation function training can improve the language function,swallowing function and the quality of life of patients with tongue cancer after free flap repair.
引文
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[13]李丽,唐恩溢,姚志清,等.系统化语音功能训练在舌癌术后软组织缺损游离皮瓣修复患者中的应用[J].江苏医药,2016,42(24):2670-2673.
[14]黄卓珊,张大明,王友元,等.早期吞咽训练对舌癌术后吞咽障碍及生活质量的影响[J].中国口腔颌面外科杂志,2017,15(3):249-253.
[15]彭翠娥,李赞,周晓,等.舌癌根治并游离皮瓣修复术患者个案护理管理研究[J].护理学杂志,2017,32(12):21-24.
[16]宋达疆,李赞,周晓,等.游离胸肩峰动脉穿支皮瓣修复舌癌术后缺损的疗效观察[J].中国修复重建外科杂志,2017,31(2):222-226.
[17]HUANG T,LIU H,ZHANG P,et al.Effect of induction chemotherapy on the quality-of-life in patients with advanced stage tongue cancer by aprospective study[J].JInt Med Resm,2018,46(4):1461-1466.
[18]ZHU L,ZHANG J,SONG X,et al.Sensory recovery of non-innervated free flaps and nasolabial island flaps used for tongue reconstruction of oncological defects[J].J Oral Rehabil,2017,44(10):736-748.
[19]宋达疆,李赞,周晓,等.游离胸肩峰动脉穿支皮瓣在口腔肿瘤术后缺损修复的临床效果[J].中华显微外科杂志,2017,40(3):222-224.
[20]肇杨,项敬周,刘法昱.前臂皮瓣、股前外侧穿支皮瓣及颏下岛状皮瓣修复舌癌患者术后生活质量评估[J].上海口腔医学,2017,26(1):111-114.
[2]朱零,施歌,陈行素,等.游离皮瓣修复舌癌术后缺损的感觉功能恢复的研究进展[J].口腔医学,2017,37(9):858-860.
[3]KIM H D,CHOI J B,YOO S J,et al.Tongue to palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors withdysphagia[J].J Oral Rehabil,2017,44(1):59-64.
[4]OHKUBO M,SUGIYAMA T,OHIRA M,et al.Swallowing rehabilitation affects period of hospitalization after surgery for tongue cancer[J].Bull Tokyo Dent Coll,2017,58(1):19-26.
[5]高升,黄焕珍,李素芬.吞咽功能训练联合针刺治疗脑卒中后吞咽障碍疗效观察[J].海南医学,2016,27(15):2531-2533.
[6]王国民,朱川,袁文化,等.汉语语音清晰度测试字表的建立和临床应用研究[J].上海口腔医学,1995,4(3):125-127.
[7]LEE Y H,LAI Y H,YUEH B,et al.Validation of the U-niversity of Washington Quality of Life Chinese Version(UWQOL-C)for head and neck cancer patients in Taiwan.[J].J Formos Med Assoc,2017,116(4):249-256.
[8]王祎,叶茂昌,王来平,等.舌癌根治性切除行前臂游离皮瓣修复重建的功能评价[J].口腔颌面外科杂志,2016,26(2):105-109.
[9]CUSTODIO C M,WISOTZKY E M.Is cancer rehabilitation fellowship training necessary for graduating physiatrists who wish to enter the field of cancer rehabilitation?[J].PM R,2017,9(9S2):S429-433.
[10]宋达疆,李赞,周晓,等.游离股内侧嵌合穿支肌皮瓣在舌癌术后缺损修复中的临床应用[J].中华耳鼻咽喉头颈外科杂志,2017,52(4):278-282.
[11]董科,邵益森,习伟宏,等.两种皮瓣修复舌癌术后缺损患者对其生存质量的影响比较[J].实用医学杂志,2016,32(21):3585-3588.
[12]孟丽,刘浩,沈军,等.前臂皮瓣与股前外侧皮瓣修复舌癌术后缺损的供区主观满意度比较[J].天津医药,2018,46(1):81-83.
[13]李丽,唐恩溢,姚志清,等.系统化语音功能训练在舌癌术后软组织缺损游离皮瓣修复患者中的应用[J].江苏医药,2016,42(24):2670-2673.
[14]黄卓珊,张大明,王友元,等.早期吞咽训练对舌癌术后吞咽障碍及生活质量的影响[J].中国口腔颌面外科杂志,2017,15(3):249-253.
[15]彭翠娥,李赞,周晓,等.舌癌根治并游离皮瓣修复术患者个案护理管理研究[J].护理学杂志,2017,32(12):21-24.
[16]宋达疆,李赞,周晓,等.游离胸肩峰动脉穿支皮瓣修复舌癌术后缺损的疗效观察[J].中国修复重建外科杂志,2017,31(2):222-226.
[17]HUANG T,LIU H,ZHANG P,et al.Effect of induction chemotherapy on the quality-of-life in patients with advanced stage tongue cancer by aprospective study[J].JInt Med Resm,2018,46(4):1461-1466.
[18]ZHU L,ZHANG J,SONG X,et al.Sensory recovery of non-innervated free flaps and nasolabial island flaps used for tongue reconstruction of oncological defects[J].J Oral Rehabil,2017,44(10):736-748.
[19]宋达疆,李赞,周晓,等.游离胸肩峰动脉穿支皮瓣在口腔肿瘤术后缺损修复的临床效果[J].中华显微外科杂志,2017,40(3):222-224.
[20]肇杨,项敬周,刘法昱.前臂皮瓣、股前外侧穿支皮瓣及颏下岛状皮瓣修复舌癌患者术后生活质量评估[J].上海口腔医学,2017,26(1):111-114.