肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2010年
10期
660-662
,共3页
鼻咽肿瘤%放射疗法%张口困难%功能锻炼
鼻嚥腫瘤%放射療法%張口睏難%功能鍛煉
비인종류%방사요법%장구곤난%공능단련
Nasopharyngeal neoplasms%Radiation therapy%Trismus%Function training
目的 探讨鼻咽癌(NPC)患者颞下颌关节(TMJ)功能锻炼对放疗后张口困难的防治效果.方法对43例行三维适形放疗(3DCRT)和82例行常规二维放疗的NPC患者,根据其临床功能锻炼执行情况分别各自分为研究组和对照组.研究组在放疗开始后即在医务人员指导和监督下进行TMJ功能锻炼;对照组首次指导后在无专人监督下让其自行完成功能锻炼.在放疗前和放疗结束后2年内末次随访时分别测量两研究组和两对照组患者的门齿距大小.结果 3DCRT研究组和对照组放疗后张口缩小程度分别为(0.64±0.59)cm和(0.81±0.64)cm(P＞0.05)、张口困难发生率分别为8.1%(2/24)和21.1%(4/19)(P＞0.05);常规二维放疗研究组和对照组放疗后张口缩小程度分别为(0.72±0.65)cm和(1.64±0.73)cm(P＜0.01)、张口困难发生率分别为19.0%(8/42)和47.5%(19/40)(P＜0.01).结论临床TMJ功能锻炼方法可减轻NPC患者放疗后张口缩小程度并降低其发生率,特别是对于行常规二维放疗的NPC患者显得尤为明显和重要.
目的 探討鼻嚥癌(NPC)患者顳下頜關節(TMJ)功能鍛煉對放療後張口睏難的防治效果.方法對43例行三維適形放療(3DCRT)和82例行常規二維放療的NPC患者,根據其臨床功能鍛煉執行情況分彆各自分為研究組和對照組.研究組在放療開始後即在醫務人員指導和鑑督下進行TMJ功能鍛煉;對照組首次指導後在無專人鑑督下讓其自行完成功能鍛煉.在放療前和放療結束後2年內末次隨訪時分彆測量兩研究組和兩對照組患者的門齒距大小.結果 3DCRT研究組和對照組放療後張口縮小程度分彆為(0.64±0.59)cm和(0.81±0.64)cm(P＞0.05)、張口睏難髮生率分彆為8.1%(2/24)和21.1%(4/19)(P＞0.05);常規二維放療研究組和對照組放療後張口縮小程度分彆為(0.72±0.65)cm和(1.64±0.73)cm(P＜0.01)、張口睏難髮生率分彆為19.0%(8/42)和47.5%(19/40)(P＜0.01).結論臨床TMJ功能鍛煉方法可減輕NPC患者放療後張口縮小程度併降低其髮生率,特彆是對于行常規二維放療的NPC患者顯得尤為明顯和重要.
목적 탐토비인암(NPC)환자섭하합관절(TMJ)공능단련대방료후장구곤난적방치효과.방법대43례행삼유괄형방료(3DCRT)화82례행상규이유방료적NPC환자,근거기림상공능단련집행정황분별각자분위연구조화대조조.연구조재방료개시후즉재의무인원지도화감독하진행TMJ공능단련;대조조수차지도후재무전인감독하양기자행완성공능단련.재방료전화방료결속후2년내말차수방시분별측량량연구조화량대조조환자적문치거대소.결과 3DCRT연구조화대조조방료후장구축소정도분별위(0.64±0.59)cm화(0.81±0.64)cm(P＞0.05)、장구곤난발생솔분별위8.1%(2/24)화21.1%(4/19)(P＞0.05);상규이유방료연구조화대조조방료후장구축소정도분별위(0.72±0.65)cm화(1.64±0.73)cm(P＜0.01)、장구곤난발생솔분별위19.0%(8/42)화47.5%(19/40)(P＜0.01).결론림상TMJ공능단련방법가감경NPC환자방료후장구축소정도병강저기발생솔,특별시대우행상규이유방료적NPC환자현득우위명현화중요.
Objective To analyze the effect of clinical temporomandibular joint (TMJ) functional training for prevention of trismus in nasopharyngeal carcinoma (NPC) patients treated with radiotherapy.Methods According to the performance of patients clinical TMJ functional training, 43 NPC patients treated with three-dimensional conformal radiation therapy (3DCRT) and 82 NPC patients treated with general twodimensional radiation therapy were assigned respectively to the study group and the contrast group. The clinical TMJ functional training on patients of the study group was performed regularly and intensively under good guidance and supervision from the beginning of radiotherapy. The clinical TMJ functional training on patients of the contrast group was performed without such strict supervison after the first guidance. The size of the distance was measured between the incisors of the patients of the study group and the contrast group before radiotherapy and the final follow-up within two years after radiotherapy. Results The reduction of the distance between the incisors were [(0.64±0.59) cm] in the study group of 3DCRT in contrast to the [(0.81±0.64) cm] in the contrast group (P ＞0.05). The incidence of trismus was 8.1% in the study group of 3DCRT in contrast to the 21.1% in the contrast group (P ＞0.05); The reduction of the distance between the incisors were [(0.72±0.65) cm] in the study group of general two-dimensional radiotherapy in contrast to the [(1.64±0.73) cm] in the contrast group (P ＜0.01). The incidence of trismus was 19.0% in the study group of general two-dimensional radiotherapy in contrast to the 47.5% in the contrast group (P ＜0.01). Conclusion TMJ Functional training method is the good method that can lower the severity and the incidence of trismus in NPC patients treated with radiotherapy. It is more evident and more important for patients with general twodimensional radiotherapy.
