個案報告：吞嚥訓練在舌癌病患之治療成效

Case Report: Effects of Swallow Training on Dysphagia Patients with Tongue Cancer

10.6143/JSLHAT.2016.04.02

楊若筠(Lo-Yun Yang)；陳美慧(Mei-Hui Chen)；鄧復旦(Simon Fu-Tan Tang)

吞嚥障礙 ； 舌癌 ； 吞嚥治療 ； 吞嚥攝影檢查 ； 生活品質 ； Dysphagia ； Tongue cancer ； Videofluoroscopic swallowing study ； Swallow training ； Quality of life

台灣聽力語言學會雜誌

35期（2016 / 04 / 01）

21 - 35

繁體中文

本研究主要探討兩位舌癌病患經舌切除術（glossectomy）、頸部廓清術（neck dissection）及放射線治療合併化學治療（concurrent chemoradiotherapy, CCRT）後，造成嚴重的吞嚥困難及進食問題，藉由語言治療師六個月的吞嚥復健訓練，改善其吞嚥及進食問題之臨床結果。語言治療師吞嚥訓練內容包括頭部抬舉手法（head lifting maneuver）、改變食物的質地並使用個案喜歡的食物進行進食訓練、口腔及咽部運動，經每週一次，共24次的復健訓練後達到臨床之成效。我們以「螢光吞嚥攝影檢查」（videofluoroscopic swallowing study, VFSS）客觀評估病患在吞嚥動作協調能力上的進步，並藉由「吞嚥障礙病患之生活品質調查表」的問卷方式，瞭解病患在接受吞嚥復健訓練之後，其生活品質滿意度的改善情形。結果發現，這兩位病患經六個月的吞嚥訓練之後，除滿足病患生理及營養的攝取外，同時也減少了病患生活上的侷限，進而改善其整體生活品質。本研究初探使用頭部抬舉手法之吞嚥復健訓練，使得病患因吞嚥困難所造成在生理或心理上的限制均可獲得改善。

Many researches have reported that glossectomy and submental resections will affect oral and pharyngeal phase of swallowing. However, up-to-date there has been limited study reporting on the rehabilitation of oral cancer patients who have dysphagia. Therefore, this study aimed to explore techniques to improve the swallowing abilities in two patients diagnosed with tongue cancer with dysphagia following glossectomy, neck dissection, and concurrent chemoradiotheapy. Both patients received the following swallowing therapy: 1. Head lifting manevuer; 2. Change of consistencies in food, and using patients' flavored food; 3. oral and pharyngeal exercise. The patients received one session of swallowing treatment per week (total of 24 sessions). The outcomes were assessed before and after treatment by videofluoroscopic swallowing study, and ＂Quality of Life in Swallowing Disorders＂ questionnaire.

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