2019 年第 12 期 第 14 卷

患者参与式自我控制对鼻咽癌放疗患者张口功能的改善作用

Self-control rehabilitation can improve mouth opening function in patients with nasopharyngeal carcinoma undergoing radiotherapy

作者：刘莹陈佩娟何玉刘倩宋琼赵晶晶

英文作者：

单位：510515广州，南方医科大学南方医院放疗科

英文单位：

关键词：鼻咽癌；放疗；患者参与式自我控制；张口功能；依从性

英文关键词：

• 摘要：

• 【摘要】目的    探讨患者参与式自我控制对鼻咽癌放疗患者张口功能的改善作用。方法    选取2015年8月至2018年2月在南方医科大学南方医院进行放疗的鼻咽癌患者89例，根据康复方法的不同将所有患者分为观察组（49例）和对照组（40例）。对照组在放疗期间给予常规康复；观察组在对照组康复的基础上给予患者参与式自我控制康复。比较2组患者放疗总有效率，放疗期间张口受限情况，放疗第1、3、6周依从性评分和放疗后生活质量评分。结果    放疗后观察组的放疗总有效率明显高于对照组［79.6%(39/49)比50.0%(20/40)］，差异有统计学意义(P=0.003)。观察组放疗期间张口受限发生率低于对照组［46.9%(23/49)比75.0%(30/40)］(P＜0.05)，且张口受限严重程度明显轻于对照组(P＜0.05)。观察组放疗第1、3、6周的康复训练依从性评分均明显高于对照组［（44±8）分比（38±6）分、（42±8）分比（36±5）分、（40±6）分比（31±4）分］，差异均有统计学意义(均P＜0.05)。放疗后观察组的疼痛、张嘴、吞咽、皮肤、言谈表达等生活质量评分均明显低于对照组，差异均有统计学意义(均P＜0.05)。结论    患者参与式自我控制应用于鼻咽癌放疗患者能改善张口功能，提高患者的依从性与治疗效果，从而提高患者的生活质量。

• 【Abstract】Objective    To investigate the effect of self-control rehabilitation on mouth opening function in patients with nasopharyngeal carcinoma undergoing radiotherapy. Methods    From August 2015 to February 2018, 89 patients with nasopharyngeal carcinoma undergoing radiotherapy in Nanfang Hospital, Southern Medical University were divided into observation group(49 cases) and control group(40 cases). The control group was treated with routine rehabilitation care. The observation group used self-control rehabilitation measures on the basis of routine rehabilitation. Efficacy of radiotherapy, mouth opening restriction during radiotherapy, patient compliance score at 1, 3, 6 weeks during radiotherapy and quality of life score after radiotherapy were analyzed. Results    The total effective rate in observation group was significantly higher than that in control group［79.6%(39/49) vs 50.0%(20/40)］(P=0.003). In observation group there was a lower incidence of mouth opening restriction［46.9%(23/49) vs 75.0%(30/40)］ and the severity of restriction was lighter as compared with control group(both P＜0.05). Scores of patient compliance at 1, 3, 6 weeks during radiotherapy in observation group were significantly higher than those in control group［（44±8） vs （38±6）, （42±8） vs （36±5）, （40±6） vs （31±4）］(all P＜0.05). Scores of pain, mouth opening, swallowing, skin and speech expression in observation group were significantly lower than those in control group(all P＜0.05). Conclusion    Self-control rehabilitation can improve the function of mouth opening, improve patient compliance and treatment effect, and improve the quality of life in patients with nasopharyngeal carcinoma undergoing radiotherapy.