虚拟现实生物反馈训练联合口腔定位疗法对口腔癌术后吞咽障碍的效果

doi:10.3969/j.issn.1006-9771.2026.04.008

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (4): 445-452.doi: 10.3969/j.issn.1006-9771.2026.04.008

虚拟现实生物反馈训练联合口腔定位疗法对口腔癌术后吞咽障碍的效果

许明霞, 朱慧, 陈飘飘, 孟可馨(), 陈杰, 陈静, 孙惠芳, 孙艳艳

浙江省人民医院耳鼻咽喉头颈外科中心-头颈中心，浙江杭州市 310014

收稿日期:2025-08-28 修回日期:2026-03-04 出版日期:2026-04-25 发布日期:2026-05-06
通讯作者: 孟可馨，E-mail： mengkexin007@gmail.com
作者简介:许明霞(1985-)，女，汉族，浙江嘉兴市人，主管护师，主要研究方向：甲状腺癌口腔颌面肿瘤术后康复训练。
孟可馨(1984-)，女，汉族，浙江杭州市人，硕士，副主任医师，主要研究方向：高危甲状腺癌的耐药机制及口腔颌面肿瘤。
基金资助:
浙江省医药卫生科技计划项目(2025KY627);浙江省医药卫生科技计划项目(2023KY024);浙江省中医药科技计划项目(2024ZL245)

Effect of virtual reality biofeedback training combined with oral positioning therapy on dysphagia after oral cancer surgery

XU Mingxia, ZHU Hui, CHEN Piaopiao, MENG Kexin(), CHEN Jie, CHEN Jing, SUN Huifang, SUN Yanyan

Department of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, China

Received:2025-08-28 Revised:2026-03-04 Published:2026-04-25 Online:2026-05-06
Contact: MENG Kexin, E-mail： mengkexin007@gmail.com
Supported by:
Zhejiang Provincial Medical and Health Science and Technology Plan Project(2025KY627);Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023KY024);Zhejiang Provincial Traditional Chinese Medicine Science and Technology Plan Project(2024ZL245)

摘要/Abstract

摘要：

目的探讨虚拟现实生物反馈训练联合口腔定位疗法在口腔癌术后吞咽障碍患者中的应用效果。

方法选取2023年5月至2024年7月于浙江省人民医院就诊的口腔癌术后吞咽障碍患者为受试者86例，随机分为对照组(n = 43)和试验组(n = 43)。对照组实施常规吞咽功能训练，试验组在此基础上采用虚拟现实生物反馈训练联合口腔定位疗法，均干预4周。干预前，干预后2周、4周和8周，分别采用标准吞咽功能评定量表(SSA)、经口摄食功能评价量表(FOIS)和安德森吞咽困难量表(MDADI)进行评定。

结果 SSA评分的组别(F = 150.190, P < 0.001, η²_p = 0.641)、时间(F = 230.870, P < 0.001, η²_p = 0.733)主效应和交互效应(F = 16.910, P < 0.001, η²_p = 0.168)均显著。FOIS评分的组别(F = 59.601, P < 0.001, η²_p = 0.415)、时间(F = 89.464, P < 0.001, η²_p = 0.516)主效应和交互效应(F = 7.990, P < 0.001, η²_p = 0.087)均显著。MDADI评分的组别(F = 33.133, P < 0.001, η²_p = 0.283)、时间(F = 49.650, P < 0.001, η²_p = 0.371)主效应和交互效应(F = 3.224, P = 0.023, η²_p = 0.037)均显著。

结论虚拟现实生物反馈训练联合口腔定位疗法可改善口腔癌术后吞咽障碍患者的吞咽功能、经口摄食能力和整体生活质量。

关键词: 口腔癌, 吞咽障碍, 虚拟现实, 生物反馈, 口腔定位疗法

Abstract:

Objective To explore the application of virtual reality biofeedback training combined with oral localization therapy in dysphagia after oral cancer surgery.

Methods From May, 2023 to July, 2024, 86 patients with dysphagia after oral cancer surgery in Zhejiang Provincial People's Hospital were randomly divided into control group (n = 43) and experimental group (n = 43). The control group received conventional swallowing function training, while the experimental group added virtual reality biofeedback training combined with oral positioning therapy, for four weeks. The Standardized Swallowing Function Assessment Scale (SSA), Functional Oral Intake Scale (FOIS) and M.D.Anderson Dysphagia Inventory (MDADI) were used for evaluation before intervention, and two weeks, four weeks and eight weeks after intervention.

Results For scores of SSA, the main effects of group (F = 150.190, P < 0.001, η²_p = 0.641) and time (F = 230.870, P < 0.001, η²_p = 0.733), as well as the interaction effect (F = 16.910, P < 0.001, η²_p = 0.168) were all significant. For scores of FOIS, the main effects of group (F = 59.601, P < 0.001, η²_p = 0.415) and time (F = 89.464, P < 0.001, η²_p = 0.516), as well as the interaction effect (F = 7.990, P < 0.001, η²_p = 0.087) were all significant. For scores of MDADI, the main effects of group (F = 33.133, P < 0.001, η²_p = 0.283) and time (F = 49.650, P < 0.001, η²_p = 0.371), as well as the interaction effect (F = 3.224, P = 0.023, η²_p = 0.037) were all significant.

Conclusion Virtual reality biofeedback training combined with oral localization therapy could improve the swallowing function, oral feeding ability and overall quality of life of patients with dysphagia after oral cancer surgery.

Key words: oral cancer, dysphagia, virtual reality, biofeedback, oral positioning therapy

中图分类号:

R767

许明霞, 朱慧, 陈飘飘, 孟可馨, 陈杰, 陈静, 孙惠芳, 孙艳艳. 虚拟现实生物反馈训练联合口腔定位疗法对口腔癌术后吞咽障碍的效果[J]. 《中国康复理论与实践》, 2026, 32(4): 445-452.

XU Mingxia, ZHU Hui, CHEN Piaopiao, MENG Kexin, CHEN Jie, CHEN Jing, SUN Huifang, SUN Yanyan. Effect of virtual reality biofeedback training combined with oral positioning therapy on dysphagia after oral cancer surgery[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(4): 445-452.

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组别	对照组(n = 43)	试验组(n = 43)	t/χ²值	P值
年龄/岁	49.28±5.67	49.44±5.72	0.897	0.130
性别/n
男	25	23	0.189	0.664
女	18	20	0.189	0.664
文化程度/n
小学及以下	17	14	0.864	0.649
初中或中专	13	12
高中以上	13	17
癌变部位/n
唇部	8	9	0.471	0.993
舌	9	10
舌根	8	7
上下颌牙龈	9	8
硬腭	4	3
颊黏膜部位	5	6
疾病诊断(TNM分期)/n
Ⅰ期	7	8	0.215	0.975
Ⅱ期	15	14
Ⅲ期	14	13
Ⅳ期	7	8
手术方式/n
单纯病灶切除术	24	22	0.187	0.665
同期行颈淋巴结清扫术	19	21	0.187	0.665
修复方式/n
直接缝合	26	20	1.683	0.195
皮瓣移植修复	17	23	1.683	0.195

变量	组别	n	干预前		干预后2周		干预后4周		随访8周
变量	组别	n	均值	标准差	均值	标准差	均值	标准差	均值	标准差
SSA评分	对照组	43	37.01	4.22	33.45	3.43	30.23	3.86	26.28	3.86
	试验组	43	37.26	4.30	26.99	2.16	24.12	2.43	21.22	2.34
FOIS评分	对照组	43	3.22	0.87	4.46	1.13	4.77	1.14	5.02	1.29
	试验组	43	3.16	0.88	5.23	1.25	6.38	1.28	6.48	1.25
MDADI评分	对照组	43	65.98	9.85	74.23	11.04	78.66	11.21	80.11	11.43
	试验组	43	66.14	9.94	82.27	13.22	86.28	13.58	89.52	8.12

虚拟现实生物反馈训练联合口腔定位疗法对口腔癌术后吞咽障碍的效果

Effect of virtual reality biofeedback training combined with oral positioning therapy on dysphagia after oral cancer surgery

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参考文献 47

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变量		平方和	自由度	均方	F值	P值	η²_p
SSA评分	组别	1609.116	1	1609.116	150.190	< 0.001	0.641
	时间	8403.465	3	2801.155	230.870	< 0.001	0.733
	组别×时间	615.512	3	205.171	16.910	< 0.001	0.168
FOIS评分	组别	61.119	1	61.119	59.601	< 0.001	0.415
	时间	319.613	2.786	114.725	89.464	< 0.001	0.516
	组别×时间	28.544	2.786	10.246	7.990	< 0.001	0.087
MDADI评分	组别	3453.779	1	3453.779	33.133	< 0.001	0.283
	时间	17531.000	3	5843.667	49.650	< 0.001	0.371
	组别×时间	1138.291	3	379.430	3.224	0.023	0.037

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