Shaker训练与下颏抗阻力训练对鼻咽癌放疗后吞咽障碍的疗效比较

doi:10.3969/j.issn.1006-9771.2017.11.016

摘要/Abstract

摘要： 目的比较Shaker训练与下颏抗阻力(CTAR)训练在鼻咽癌放疗后吞咽障碍中的疗效。方法 2015年8月至2017年2月,鼻咽癌放疗后吞咽障碍患者90例随机均分为对照组、Shaker组和CTAR组。对照组予常规吞咽训练,Shaker组加用Shaker训练法,CTAR组加用CTAR训练。训练前及训练2周、4周和6周后,电视荧光透视检查(VFSS)评定渗透-误吸程度。结果干预前三组间VFSS评级无显著性差异(F=0.551, P>0.05)。干预后,对照组评级无显著性变化(F=1.774, P>0.05),其余两组均显著下降(F>5.317, P<0.001);Shaker组和CTAR组在治疗4周和6周后,评级均显著低于对照组(P<0.001),Shaker组和CTAR组之间无显著性差异(P>0.05)。CTAR组(86.67%)和Shaker组(76.67%)总有效率高于对照组(43.33%) (χ²>2.079, P<0.05),Shaker组和CTAR组之间无显著性差异(P>0.05)。结论对鼻咽癌放疗后吞咽障碍,CTAR训练能取得与Shaker训练相似的康复效果,但更易为患者接受。

关键词: 鼻咽癌, 放射疗法, 吞咽障碍, Shaker训练, 下颏抗阻力训练

Abstract: Objective To compare the effect of Shaker exercise and Chin Tuck Against Resistance (CTAR) exercise on dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC).Methods From August, 2015 to February, 2017, 90 patients with dysphagia after radiotherapy for NPC were randomly divided into control group, Shaker group and CTAR group equally. The control group received routine swallowing training, while the Shaker group accepted Shaker exercise and CTAR group accepted CTAR exercise in addition. They were assessed with Penetration-Aspiration Scale under video fluoroscopic swallowing study (VFSS) before, and two weeks, four weeks and six weeks after exercise.Results There was no significant difference in VFSS score among the three groups before intervention (F=0.551, P>0.05). The score decreased after intervention in Shaker group and CTAR group (F>5.317, P<0.001), but varied less in the control group (F=1.774, P>0.05). However, it was less in Shaker group and CTAR group than in the control group (P<0.001), and it was not significantly different between Shaker group and CTAR group after 4 weeks and 6 weeks of intervention (P>0.05). The total effective rate was 86.67% in CTAR group and 76.67% in Shaker group, that was significantly higher than 43.33% in the control group (χ²>2.079, P<0.05), and it was not significantly different between Shaker group and CTAR group (P>0.05).Conclusion CTAR exercise is effective on dysphagia after radiotherapy for NPC, which is similar to those of Shaker exercise, and more acceptable and easier to persist.

Key words: nasopharyngeal carcinoma, radiotherapy, dysphagia, Shaker exercise, Chin Tuck Against Resistance exercise

中图分类号:

R739.6

尤慧玲, 龙耀斌. Shaker训练与下颏抗阻力训练对鼻咽癌放疗后吞咽障碍的疗效比较[J]. 《中国康复理论与实践》, 2017, 23(11): 1317-1320.

YOU Hui-ling, LONG Yao-bin. Comparison of Shaker Exercise and Chin Tuck Against Resistance Exercise for Radiation-induced Dysphagia after Nasopharyngeal Carcinoma[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(11): 1317-1320.

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