吞咽康复对头颈癌患者吞咽功能及生活质量效果的Meta分析

doi:10.3969/j.issn.1006-9771.2019.07.002

摘要/Abstract

摘要： 目的评价吞咽康复对头颈癌患者吞咽障碍和生活质量的影响。方法检索中国知网、万方医学网、维普中文期刊、中国生物医学文献服务系统，以及PubMed、Embase、Cochrane Library、Ovid、EBSCO、Web of Science等数据库，筛选文献，评价纳入文献质量。采用RevMan 5.3软件，从吞咽功能、经口摄食功能和生活质量三个方面评价吞咽康复对头颈癌患者的效果。结果共纳入24篇文献，1514例患者。吞咽功能：吞咽X线荧光透视检查RR = 1.67, 95%CI 1.37~2.04；标准吞咽功能评估量表MD = -6.43, 95%CI -8.41~-4.45；洼田饮水试验RR = 1.82, 95%CI 1.56~2.11；口咽吞咽效率MD = -0.41, 95%CI -7.41~6.59。经口摄食功能：功能性经口摄食量表MD = 1.58, 95%CI 0.67~2.49。生活质量：安德森吞咽困难量表，3个月内MD = 0.07, 95%CI -1.30~1.44；3~6个月MD = -1.74, 95%CI -3.40~-0.07；6~9个月MD = -1.36, 95%CI -3.15~0.42；癌症患者生活质量测定量表，3个月内一项研究显示训练组评分低于对照组(P = 0.03)，另一项研究显示训练组评分高于对照组(P < 0.05)；3~6个月MD = 10, 95%CI 1.83~18.17；6~9个月MD = 2.20, 95%CI -5.57~9.98；9~12个月MD = -1.76, 95%CI -10.73~7.21。结论吞咽康复可改善头颈癌患者的吞咽功能和经口摄食功能，但对生活质量的改善还需更多证据支持。

关键词: 头颈癌, 吞咽障碍, 康复, 生活质量, Meta分析

Abstract: Objects To evaluating the effect of swallowing rehabilitation on the quality of life and swallowing function in head and neck cancer patients. Methods The literatures were retrieved from databases of CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Cochrane Library, Ovid, EBSCO and Web of Science. They were scanned and assessed, and analyzed with RevMan 5.3 in the terms of swallowing function, oral feeding function and quality of life. Results A total of 24 trials that represented 1514 participants were evaluated. For the swallowing function, by videofluoroscopic swallowing study, RR = 1.67, 95%CI 1.37 to 2.04; by Kubota Water Swallowing Test, RR = 1.82, 95%CI 1.56 to 2.11; by Standardized Swallowing Assessment, MD = -6.43, 95%CI -8.41 to -4.45; by Oropharyngeal Swallowing Efficiency, MD = -0.41, 95%CI -7.41 to 6.59. For oral feeding function, by Functional Oral Intake Scale, MD = 1.58, 95%CI 0.67 to 2.49. For quality of life, by Anderson Dysphagia Inventory, within three months, MD = 0.07, 95%CI -1.30 to 1.44; three to six months, MD = -1.74, 95%CI -3.40 to -0.07; six to nine months, MD = -1.36, 95%CI -3.15 to 0.42; by European Organization for Research on Treatment of Cancer Quality of Life Questionaire, within three months: a research displayed that the score was less in the training group than in the control group (P = 0.03), another research displayed that the score was more in the training group than in the control group (P < 0.05); three to six months, MD = 10, 95%CI 1.83 to 18.17; six to nine months, MD = 2.20, 95%CI -5.57 to 9.98; nine to twelve months, MD = -1.76, 95%CI -10.73 to 7.21. Conclusion Swallowing rehabilitation can improve the swallowing function and the oral feeding function for the head and neck cancer patients, however, it is needed more evidence to support the improvement on the quality of life.

Key words: head and neck cancer, swallowing disorders, rehabilitation, quality of life, meta-analysis

中图分类号:

R739.91

孙予祥, 贾雪丽, 廖书帆, 杨彦. 吞咽康复对头颈癌患者吞咽功能及生活质量效果的Meta分析[J]. 《中国康复理论与实践》, 2019, 25(7): 751-760.

SUN Yu-xiang, JIA Xue-li, LIAO Shu-fan, YANG Yan. Effect of Swallowing Rehabilitation on Swallowing Function and Quality of Life for Head and Neck Cancer Patients: A Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(7): 751-760.

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