鼻咽癌患者放疗后吞咽功能的随访观察

目的:评估鼻咽癌患者放疗后1年内吞咽功能的变化情况。方法:对50例放疗后出现吞咽障碍的患者进行回顾性分析,在放疗前、放疗后1个月、6个月、1年所有患者均填写吞咽调查问卷和接受电视透视吞咽功能检查(VFSS),观察患者吞咽情况的变化。结果:吞咽调查问卷结果显示,鼻咽癌患者在放疗后1个月开始出现吞咽困难症状(P<0.05);咽后软组织水肿、吞咽疼痛发病率在放疗后1个月显著上升,但随着放疗结束时间的增加而下降,差异均有统计学意义(P<0.05);VFSS检查评估结果显示,不同性状食物的咽期传送时间在放疗后呈逐渐延长趋势至随访结束(P<0.05):放疗后1个月会厌部残留开始出现,但随放疗结束时间的趋于稳定,差异有统计学意义(P<0.05)。结论:鼻咽癌患者在放疗结束后1个月吞咽困难的症状达到高峰,并随放疗结束时间的增加患者主观的吞咽困难的症状呈逐渐减轻趋势,但咽期食物运送时间却呈逐渐延长的趋势,并在放疗1年后趋于稳定。

Follow-UP for Swallowing Function of Patients with Nasopharyngeal Carcinoma after Radiotherapy

Objective:To evaluate over a 1-year period the serial swallowing function of patients with nasopharyngeal carcinoma after completing radiotherapy(RT).Methods:A prospective longitudinal follow-up was performed on 50 nasopharyngeal carcinoma(NPC)patients with dysphagia,who completed RT.The serials wallowing function of these patients was measured at four given time before and after RT by questionnaire and Videofluoroscopic Swallowing Study(VFSS).Results:The results of questionnaire demonstrated swallowing impairment may occur in irradiated patients with NPC as early as 1 month after completing RT(P<0.05).The incidence of retropharyngeal soft tissue swelling and"pain during swallowing"significantly increased in the first month after RT and decreased over time(P<0.05).VFSS showed that Pharyngeal transit time was prolonged continuously up to 1 year after RT(P<0.05).Epiglottis vallecula stasis was worst in the first month after RT and would be stable afterwards(P<0.05).Conclusion:The symptoms of dysphagia peaked patients with NPC 1 month after completing RT,and the subjective symptoms of dysphagia gradually decreased after RT,but the time of pharyngeal transit time gradually increased,and tended to be stable after 1 year of completing RT.