Effect Of Direct Feeding Training On Swallowing Rehabilitation In Patients With Tongue Cancer Surger

Objective: Explore the effects of direct feeding training on swallowing function,quality of life and gastric tube extubation in patients with dysphagia after tongue cancer surgery,and to evaluate the application effect of direct feeding training in patients with dysphagia after tongue cancer surgery.Methods: Adopt of experimental research design.60 with tongue cancer who were hospitalized in a top three hospital in Changsha and met the exclusion criteria from July 2020 to July 2021 were selected,and the two diseases were randomly divided into control groups by coin toss(n=30)and intervention group(n=30).The control group received routine swallowing training and nursing care during hospitalization,and was given continued follow-up care by continuing care platform once a week.the intervention group implemented direct feeding training of a total of 2months,except for the basis of swallowing training,nursing care and continued follow-up care by continuing care platform once a week.Before the intervention,2weeks after the intervention,1 month after the intervention,2 months after the intervention,the drinking water test,The Functional Oral Intake Scale(FOIS),Swallowing-related Quality of Life(SWAL-QOL)and removal rate of gastric tube to evaluate the effect of intervention.IBM SPSS25.0 statistical software was used for statistical analysis of the data.In general data,measurement data were compared with two samples t-test,and enumeration data were compared with chi-square test;Wilcoxon rank sum test and chi-square test were used to compare drinking water test between the two groups;Repeated measurement analysis of variance was used to compare FOIS and SWal-QOL scores at different time points,paired t-test was used for intra-group comparison,and two samples t-test was used for inter-group comparison.Results:1.Before the intervention,the general information,drinking water test,FOIS,SWAL-QOL and removal rate of gastric tube of the two groups were not statistically significant(P> 0.05),and were comparable.2.Comparison of drinking water test between two groups(1)Wilcoxon rank sum test analysis results showed that there is statistics significant(P<0.05)on the drinking water test of the two groups before intervention,2 weeks after intervention,1 month after intervention and 2 months after intervention;(2)Using chi-square test analysis results showed that two weeks after the intervention,the intervention group and control group cure rate of 0,and the significant efficiency and total improvement rate of the intervention group(60.0%)were higher than the control group(23.3%),with statistically significant differences(P<0.05);One month after intervention,the cure rate of the intervention group(33.3%)was significantly better than that of the control group(0%),and the difference was statistically significant(P<0.05).There was no significant difference in the effective rate between the intervention group(53.3%)and the control group(53.3%)(P>0.05),but the total improvement rate of the intervention group(86.7%)was higher than that of the control group(53.3%),and the difference was statistically significant(P<0.05);Two months after intervention,the cure rate of the intervention group(66.7%)was significantly better than that of the control group(16.7%),the difference was statistically significant(P<0.05),the effective rate of the intervention group(23.3%)was lower than that of the control group(43.3%),but the difference was not statistically significant(P>0.05),and the total improvement rate of the intervention group(90.0%)was higher than that of the control group(60.0%),the difference was statistically significant(P<0.05).3.Comparison of FOIS scores between the two groups(1)Repeated measurement analysis of variance showed that the intervention effect,time effect and interaction effect of FOIS score in 2 groups were statistically significant(P<0.05);(2)In comparison between groups at different measurement time points,The FOIS scores of the intervention group after the the intervention for 1 month and 2months were higher than the control group,with statistically significant differences(P<0.05).(3)Intra-group comparison at different measurement points showed that FOIS scores of in the intervention group and control group were higher than the baseline at2 weeks,1 month and 2 months after intervention,with statistically significant differences(P<0.05).4.Comparison of SWAL-QOL scores between the two groups(1)Repeated analysis of variance analysis results showed that SWAL-QOL total score and each dimension score of patients were affected by the intervention effect,time effect and interaction effect(P<0.05),The difference was statistically significant;(2)In comparison between groups at different measurement time points,the total SWAL-QOL score and the scores of all dimensions in the intervention group after the the intervention for 1 month and 2 months were higher than the control group,with statistically significant differences(P<0.05);(3)Intra-group comparison at different measurement time points showed that the total SWAL-QOL score and the scores of all dimensions in the intervention group after the the intervention for 2 weeks,1 month and 2 months were higher than the control group,with statistically significant differences(P<0.05).In the control group,scores of other dimensions were higher than before intervention,with statistical significance(P<0.05),except ideological burden dimension 2 weeks after intervention,1 month after intervention,and eating time dimension 2 weeks after intervention.5.Comparison of gastric tube removal rate between the two groups after interventionThe extubation rate of gastric tube in the intervention group(70.0%)was higher than the control group(33.3%)at 2 weeks after intervention,the difference was statistically significant(P<0.05);The extubation rate in the intervention group(83.3%)was higher than the control group(73.3%)at 1 month after intervention,but the difference was not statistically significant(P=0.347);The extubation rate of gastric tube in the intervention group(96.7%)was higher than the control group(76.7%)at 2months after intervention,the difference was statistically significant(P<0.05).Conclusions:The directly feeding training can promote the recovery of swallowing function in postoperative patients with tongue cancer;To improve the psychological status,eating status,swallowing symptoms and physical function of patients after tongue cancer surgery,and improve the quality of life;It can promote early oral feeding,improve the safety and effectiveness of eating,and shorten the indwelling time of gastric tube,which is worthy of clinical application.