头颈部鳞状细胞癌术后早期吞咽障碍的临床相关因素

目的 了解头颈部鳞状细胞癌(HNSCC)患者术后早期吞咽障碍的临床相关因素。 方法 对2019年10月至2021年4月在重庆医科大学附属第一医院颌面外科首次接受根治性外科手术治疗HNSCC患者80例,术后2周采用洼田饮水试验、功能性经口摄食量表(FOIs)和M.D.安德森吞咽困难评分量表(MDADI)对患者吞咽功能进行筛查和评价,收集相关随访资料,进行回顾性分析。 结果 HNSCC患者吞咽障碍发生率91.25%。单因素分析显示,肿瘤T分期、部位,同期进行皮瓣修复、颈清扫均会对术后早期吞咽功能产生影响(P < 0.05)。多因素分析显示,肿瘤T分期是吞咽障碍的独立影响因素(B = -5.092, t = -6.770, P < 0.001)。 结论 建议常规评估HNSCC患者术后的吞咽功能,特别是恶性程度高的患者,以便及早干预。

Factors related to dysphagia early after surgery for head-and-neck squamous cell carcinoma

Objective To explore factors related to dysphagia early after surgery for head-and-neck squamous cell carcinoma (HNSCC). Methods A total of 80 HNSCC inpatients in Department of Oral and Maxillofacial Surgery, the Frist Affiliated Hospital of Chongqing Medical University, from October, 2019 to April, 2021, were reviewed swallowing function with Kubota water drinking test, Functional Oral Intake Scale (FOIs) and M.D. Anderson Dysphagia Inventory (MDADI), two weeks after radical surgery for the first time; while the related data were collected and analyzed. Results The incidence of early post-operative dysphagia was 91.25%. The T stages of the tumor, the location of the primary tumor, simultaneous flap repairment and neck dissection were the factors related to dysphagia (P < 0.05), and T stages of the tumor was the independent factor (B = -5.092, t = -6.770, P < 0.001). Conclusion It's necessary to evaluate the swallowing function of HNSCC patients after surgery, especially for those in worse stages, for early intervention.