早期口腔運動對口腔癌病人術後張口困難及生活品質之改善成效

The effects of early oral exercise on trismus and quality of life among oral cancer patient after surgery

黃珮蓁(Pei-Chen Huang)

指導教授 ： 林佑樺

義守大學/醫學院/護理學系/碩士(2017年)

摘要

研究目的:探討早期口腔運動介入，對口腔癌術後病人的張口度改善及生活品質之成效。
方法:本研究以兩組前、後測類實驗性設計。以初次罹患口腔癌並接受口腔手術之病人為對象，採隨機分配方式分為實驗組45人及對照組45人。兩組研究對象均於手術前一日接受張口度測量，且於手術前一日與出院前共接受兩次口腔復健運動衛教。實驗組再增加於術後第7-10天開始接受口腔簡易運動，對照組則於住院中依照一般護理指導未再給予任何介入性措施。
本實驗結果:實驗組前、後測平均張口度值增加0.32cm(±0.39cm)，呈顯著差異(Z=-4.56，p<0.05)。對照組前、後測張口平均值增加0.07cm(±0.19cm)，呈顯著差異Z=-3.88，p <.05)。於生活品質之吞嚥問題有顯著差異（Z＝-2.63，p＜0.05），跟診斷前一個月比目前自己的健康狀況（Z＝-3.56，p＜0.05）；目前的生活品質（Z＝-.50，p＜0.05）；促進生活品質項目程度(Z＝-5.12，p＜0.05)，皆有顯著差異。
結論:手術後實驗組早期口腔運動介入，於改善口腔癌術後病人張口度有顯著差異，因張口度改善對於生活品質提升皆有顯著差異。冀期此成效結果提供臨床醫護人員參酌，以提升病人照護品質。

關鍵字

口腔癌 ； 張口困難 ； 生活品質

並列摘要

Purpose: The purpose of this study was to investigate the effect of early oral exercise on the improvement of oral opening and quality of life in oral cancer patients of post-surgery.
Method: This study was based on two groups of experimental design. Patients with oral cancer who underwent oral surgery for the first time were randomly divided into experimental group (n=45) and control group (n=45) Participants were randomized in two group, one is receiving early open-month training (experimental group, n=45), and the others is receiving reqular care (control group, n=45), there is no extra intervention care in control group. The experimental group participants keep simple oral exercise form 7th-10th day after surgery, and continue every day for a month. Mouth open size were measured and followed up with the patients before surgery (T0), first week (T1), and a month (T2) after discharge.
Result: The MMO improvement of the experimental group were 0.32cm (± 0.39cm), was statistically significantly different (Z = -4.56, p <0.05). The MMO improvement of the control group were 0.07cm (±0.19cm), showing statistically significant difference (Z = -3.88, p <0.05). The experimental group also demonstrated a statistically significant improvement in swallowing (Z = -2.63, p <0.05), Health-related quality of life(QOL)compared to month before had cancer (Z = -3.56, p <0.05),Health-related QOL during the past 7 days （Z＝-0.50，p＜0.05） and Overall QOL during the past 7 days(Z = -5.12, p <0.05).
Conclusions: This study confirmed that intervention of early open-month training helps to improve trismus issue in oral cancer patients. There was statistically significant difference in the improvement of mean mouth opening ,swallowing function , Health-related QOL and Overall QOL . Health care providers should initiate the open-mouth training after oral surgery earlier, and consider it in patients’ care plans as a part of continuous following up to improve caring quality.

並列關鍵字

oral cancer ； trismus ； quality of life(QOL)

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