头颈肿瘤放化疗患者吞咽困难预防性训练指导方案的最佳证据总结

doi:10.16460/j.issn1008-9969.2023.02.054

摘要/Abstract

摘要： 目的总结头颈肿瘤放化疗患者吞咽困难预防性训练的最佳证据,为临床医护人员提供参考。方法系统检索关于头颈肿瘤放化疗患者吞咽困难预防性训练的临床决策、指南、专家共识、证据总结、系统评价证据,检索时间为建库至2022年4月,由2名经过循证培训的研究人员独立对文献进行质量评价和证据级别评定。结果共纳入11篇文献,包括3篇临床决策、2篇指南、1篇证据总结、2篇专家共识、3篇系统评价,从多学科团队、健康教育、危险因素、评估和筛查、预防性训练内容、疼痛控制、基础口腔护理、食物和进食姿势的调整、知情同意9个方面汇总了22条最佳证据。结论临床医护人员可参考头颈肿瘤放化疗患者吞咽困难最佳证据,结合临床情境和患者意愿,为头颈肿瘤放化疗患者提供个性化的预防性训练指导。

关键词: 头颈肿瘤, 放化疗, 吞咽困难, 预防性训练, 循证护理

中图分类号:

R473.73

吕俭霞, 叶丽, 李彬, 吴波, 张含凤, 江庆华, 殷利. 头颈肿瘤放化疗患者吞咽困难预防性训练指导方案的最佳证据总结[J]. 护理学报, 2023, 30(2): 54-59.

参考文献

[1] 孙燕. 临床肿瘤学[M].北京:中华医学电子音像出版社,2017:357-373.
[2] Bray F, Ferlay J, Soerjomataram I, et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2018,68(6):394-424.DOI:10.3322/caac.21492.
[3] Caudell JJ, Gillison ML, Maghami E,et al.NCCN guidelines^® insights: head and neck cancers,version 1.2022[J]. J Natl Compr Canc Netw, 2022, 20(3):224-234. DOI: 10.6004/jnccn.2022.0016.
[4] Nguyen NP, Moltz CC, Frank C, et al.Evolution of chronic dysphagia following treatment for head and neck cancer[J]. Oral Oncol, 2006,42(4):374-380. DOI:10.1016/j.oraloncology.2005.09.003.
[5] Dysphagia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO), et al. Swallowing dysfunction in cancer patients[J]. Support Care Cancer, 2012, 20(3):433-443. DOI: 10.1007/s00520-011-1342-2.
[6] Carroll WR, Locher JL, Canon CL, et al.Pretreatment swallowing exercises improve swallow function after chemoradiation[J]. Laryngoscope, 2008,118(1):39-43. DOI:10.1097/MLG.0b013e31815659b0.
[7] Dicenso A, Bayley L, Haynes RB.Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009,12(4):99-101. DOI:10.1136/ebn.12.4.99-b.
[8] Brouwers M, Kho ME, Browman GP, et al.AGREE II: Advancing guideline development, reporting and evaluation in healthcare[J]. CMAJ, 2010,182(18):E839-E842. DOI: 10.1503/cmaj.090449.
[9] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: advancing guideline development, reporting, and evaluation in health care[J]. Prev Med, 2010,51(5):421-424. DOI: 10.1016/j.ypmed.2010.08.005.
[10] The Joanna Briggs Institute (JBI). Joanna Briggs Institute Reviewers Manual2017[EB/OL].(2022-10-30)https://bibleappsfree.com/2022/07/joanna-briggs-institute-reviewers-manual-2017/.
[11] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志, 2015, 30(11):964-967. DOI:10.16821/j.cnki.hsjx.2015.11.002.
[12] Lewin JS, Teng MS,Kotz T,et al. 头颈癌患者的言语及吞咽功能康复.UpToDate临床顾问[EB/OL].(2022-10-30). http://www.uptodate.cn.https.scch.proxy.dayi100.com/contents/zh-Hans/speech-and-swallowing-rehabilitation-of-the-patient-with-head-and-neck-cancer.
[13] Galloway T, Amdur RJ.头颈癌初始治疗期间并发症的处理与预防.UpToDate临床顾问[EB/OL].(2022-10-30). http://www.uptodate.cn.https.scch.proxy.dayi100.com/contents/zh-Hans/management-and-prevention-of-complications-during-initial-treatment-of-head-and-neck-cancer.
[14] Galloway T, Amdur RJ. 头颈癌及其治疗的晚期并发症的处理.UpToDate临床顾问[EB/OL].(2022-10-30). http://www.uptodate.cn.https.scch.proxy.dayi100.com/contents/zh-Hans/management-of-late-complications-of-head-and-neck-cancer-and-its-treatment.
[15] Malagelada JR, Bazzoli F, Boeckxstaens G, et al.World Gastroenterology Organisation Global Guidelines: Dysphagia-global guidelines and cascades update september 2014[J]. J Clin Gastroenterol, 2015, 49(5):370-378. DOI: 10.1097/MCG.0000000000000307.
[16] Clarke P, Radford K, Coffey M, et al.Speech and swallow rehabilitation in head and neck cancer: United Kingdom national multidisciplinary guidelines[J]. J Laryngol Otol, 2016, 130(S2):S176-S180.DOI:10.1017/S0022215116000608.
[17] Abdulsalam A. Nasopharyngeal carcinoma: dysphagia[EB/OL]. (2022-10-30). The JBI EBP Database. 2021; JBI-ES-3686-2.
[18] Schindler A, Denaro N, Russi EG, et al.Dysphagia in head and neck cancer patients treated with radiotherapy and systemic therapies: literature review and consensus[J]. Crit Rev Oncol Hematol, 2015,96(2):372-384. DOI:10.1016/j.critrevonc.2015.06.005.
[19] Baijens LWJ, Walshe M, Aaltonen LM, et al.European white paper: oropharyngeal dysphagia in head and neck cancer[J]. Eur Arch Otorhinolaryngol, 2021,278(2):577-616. DOI: 10.1007/s00405-020-06507-5.
[20] Yang W, Nie W, Zhou X, et al.Review of prophylactic swallowing interventions for head and neck cancer[J]. Int J Nurs Stud, 2021,123:104074.DOI:10.1016/j.ijnurstu.2021.104074.
[21] Banda KJ, Chu H, Kao CC, et al.Swallowing exercises for head and neck cancer patients: a systematic review and meta-analysis of randomized control trials[J]. Int J Nurs Stud, 2021(114):103827. DOI:10.1016/j.ijnurstu.2020.103827.
[22] 薛少军. 吞咽训练对头颈部肿瘤放疗后吞咽困难的防治效果Meta分析[D].太原:山西医科大学,2021.
[23] Perry A, Lee SH, Cotton S, et al. Therapeutic exercises for affecting post-treatment swallowing in people treated for advanced-stage head and neck cancers[J]. Cochrane Database Syst Rev, 2016,2016(8):CD011112.DOI:10.1002/14651858.
[24] Greco E, Simic T, Ringash J, et al.Dysphagia treatment for patients with head and neck cancer treated with radiotherapy: a meta-analysis review[J]. Int J Radiat Oncol Biol Phys, 2018,101(2):421-444.DOI:10.1016/j.ijrobp.2018.01.097.
[25] Long YB, Wu XP.A randomized controlled trail of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of radiation-induced dysphagia in nasopharyngeal carcinoma patients[J]. Disabil Rehabil,2013,35(6):450-454.DOI:10.3109/09638288.2012.697250.
[26] Wang YJ, Chen WX, Zhang JL, et al.Cervical oesophagostomy in patients with severe dysphagia following radiotherapy for nasopharyngeal carcinoma[J]. J Laryngol Otol, 2014,128(2):142-146. DOI:10.1017/S0022215113003423.
[27] 刘祚燕,龙纳,王凤英, 等.吞咽困难康复的跨学科合作现状及展望[J].护理研究,2016,30(30):3719-3722. DOI:10.3969/j.issn.1009-6493.2016.30.003.
[28] Christmas C, Rogus-Pulia N.Swallowing disorders in the older population[J]. J Am Geriatr Soc, 2019,67(12):2643-2649. DOI:10.1111/jgs.16137.
[29] 方跃艳,任海燕.卒中后吞咽障碍的康复干预研究进展[J].护士进修杂志,2022,37(6):516-519. DOI:10.16821/j.cnki.hsjx.2022.06.007.
[30] 罗媛容,陈妙霞,安德连, 等.吞咽专科护联体的构建与初步实践[J].护理研究,2020,34(13):2409-2412. DOI:10.12102/j.issn.1009-6493.2020.13.032.
[31] 杨海燕,张薇薇,姚畑, 等.专科护士主导的多学科团队在卒中急性期吞咽障碍分级管理护理实践中的应用研究[J].全科护理,2022, 20(24):3313-3318. DOI:10.12104/j.issn.1674-4748.2022.24.001.
[32] 侯坤华,李芊芊,彭燕秋,等.预防性吞咽训练在头颈部肿瘤放化疗患者的应用进展[J].护理学报,2021,28(13):24-28. DOI:10.16460/j.issn1008-9969.2021.13.024.
[33] Hegland KW, Murry T.Nonsurgical treatment: swallowing rehabilitation[J]. Otolaryngol Clin North Am, 2013,46(6):1073-1085. DOI: 10.1016/j.otc.2013.08.003.
[34] Carnaby-Mann G, Crary MA, Schmalfuss I, et al."Pharyngocise": randomized controlled trial of preventative exercises to maintain muscle structure and swallowing function during head-and-neck chemoradiotherapy[J]. Int J Radiat Oncol Biol Phys, 2012,83(1):210-219.DOI:10.1016/j.ijrobp.2011.06.1954.
[35] Hajdú SF, Christensen MB, Kristensen MØ, et al.Adherence to preventive swallowing exercises for head and neck cancer patients undergoing (chemo)radiotherapy treatment[J].Acta Oncol, 2019,58(5):658-664.DOI:10.1080/0284186X.2018.1563715.
[36] Shinn EH, Basen-Engquist K, Baum G, et al.Adherence to preventive exercises and self-reported swallowing outcomes in post-radiation head and neck cancer patients[J]. Head Neck, 2013, 35(12):1707-1712. DOI:10.1002/hed.23255.
[37] Kaizer F, Spiridigliozzi AM, Hunt MR.Promoting shared decision-making in rehabilitation: development of a framework for situations when patients with dysphagia refuse diet modification recommended by the treating team[J]. Dysphagia, 2012, 27(1):81-87. DOI:10.1007/s00455-011-9341-5.

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