Objective To investigate the preventive effect of psychological intervention combined with cod liver oil ointment on radiation nasal inflammation in nasopharyngeal carcinoma patients. Methods 90 patients with nasopharyngeal carcinoma treated in our hospital from January 2015 to December 2016 were randomly divided into study group and control group. The control group was treated with nasopharyngeal irrigation. The study group was given psychological intervention combined with cod liver oil ointment. Results The treatment effect of the study group was significantly better than that of the control group, and the incidence of radiation rhinitis was significantly lower than that of the control group. There was no significant difference between the two groups before the endoscopic score, the CT score of the sinus and the cilia transmission rate Improved, the study group was significantly better than the control group(P<0.05); before treatment, the two groups of patients with no significant differences in clinical symptoms, after treatment have been improved, the study group was significantly better than the control group(P<0.05). Conclusion The application of psychological intervention combined with cod liver oil ointment in radiotherapy of nasopharyngeal carcinoma is beneficial to prevent radiation rhinitis and improve the function of sinus function.

Objective:To study the changes of food characters in early swallowing recovery in patients with different laryngeal function preservation surgery.Methods:Collected patients with laryngeal cancer hypopharyngeal cancer who underwent laryngeal function preservation surgery in Lihuili Hospital of Ningbo Medical Center from January 2019 to March 2020. By fiberoptic endoscopic evaluation of swallowing (FEES) combined with Penetration and Aspiration Scale (PAS), prospectively observed the aspiration and invasion of solid, paste, fluid and other food in the early stage of trial feeding in patients with laryngeal hypopharyngeal cancer undergoing open laryngeal function preservation.Results:Among the 69 patients, 21 had vertical partial laryngectomy and 19 had partial pharyngeal partial laryngectomy. 15 days after the operation, 2 groups of patients after solid and paste food adaptability scored (1.14±0.36), (1.29±0.56) and (2.53±2.04), (2.84±2.31) points, Friedman Mtest for comparison difference had statistical significance ( Mvalues were 23.463 and 22.227, P<0.01); the liquid food for adaptability scored (2.10±1.09), (4.42±2.24) points, the pairwise comparison of liquid, solid and paste showed statistically significant differences ( tvalues were-0.976 to 1.105, P<0.05). The pairwise comparison of the adaptability of the two groups on 20 days after surgery showed no statistically significant difference ( P>0.05).Throat on the cricoid cartilage resection-ring hyoid epiglottis anastomosis (SLCP-CHEP) was 17 cases, laryngeal glottis level partial resection was 12 cases; postoperative 15 days the adaptability on the behavior of three kinds of food grade 2 groups of patients (4.65±1.90), (5.59±1.46), (6.53±1.13) points and (6.67±1.07), (4.50±2.07), (6.92±0.79) points, respectively; Minspection differences were statistically significant ( Mvalues were 29.525, 22.136, P<0.01).The pairwise comparison of solid and paste food in the two groups 20 days after the operation showed no statistically significant difference ( P>0.05), while the difference of liquid and paste was statistically significant ( tvalues were-1.375 to-0.853, P<0.05). Conclusion:In the early recovery of patients undergoing laryngeal function preservation surgery, the vertical group and the partial pharyngeal partial laryngectomy group has better adaptability to solid and paste food. The horizontal group has better adaptability to paste, the CHEP group has better adaptability to solid, and the four groups has the worst adaptability to convection, the recovery time of convective mass between the CHEP group and the horizontal group was longer. To understand the adaptability of patients with different surgical methods to food traits at the early stage of trial feeding can help to implement targeted rehabilitation programs, carry out progressive diet training, and reduce the complications of misinvasion, aspiration, aspiration pneumonia and other complications in the recovery cycle.

Objective? To explore the application of Gugging Swallowing Screen(GUSS) in swallowing rehabilitation of patients after laryngeal function preservation operation. Methods? Using convenience sampling method, 110 patients with first diagnosed laryngeal cancer who underwent laryngeal function preservation operation from February 2016 to February 2018 in two Class Ⅲ Grade A hospitals in Ningbo were selected as subjects. By complete random method, the patients were divided into control group (n=50) and intervention group (n=49). Patients in the control group were given routine nursing care, relying on the sphincter function of the residual larynx to gradually compensate for the recovery of swallowing function, and the nasogastric tube was removed after eating fluids without obvious cough. The intervention group used GUSS scale to guide swallowing rehabilitation training once they started eating. The nasogastric feeding tube was removed when GUSS score equaled or exceeded 17. The swallowing function, indwelling time of nasogastric tube, re-intubation rate of nasogastric tube, incidence of aspiration pneumonia and patients' confidence in recovery were compared between the two groups. Results? The recovery of swallowing function in the intervention group was better than that in the control group at 3 and 4 weeks after operation (P＜0.05). The self-efficacy score of intervention group was better than that of control group at 2, 3 and 4 weeks after operation (P＜0.05). The indwelling time of nasogastric tube in the intervention group was shorter than that in the control group (P＜ 0.05), and there was no statistical difference in the re-intubation rate of nasogastric tube between the two groups (P＞ 0.05). The incidence of aspiration pneumonia in intervention group was lower than that in control group (P＜ 0.05). Conclusions? Using GUSS scale to guide swallowing training for patients after laryngeal function preservation operation can effectively promote the recovery of swallowing function, shorten the indwelling time of nasogastric feeding tube, reduce the incidence of aspiration pneumonia,and improve patients' confidence in recovery.

Objective:To explore the effects of different surgical treatments on swallowing function in partial laryngectomy patients and to analyze the development trend of swallowing function.Methods:From January 2019 to September 2019, this study selected 54 patients first diagnosed as laryngeal carcinoma with partial laryngectomy at a ClassⅢ Grade A hospital as subjects by convenience sampling. There were 25 patients with vertical partial laryngectomy (vertical group) , 12 patients with horizontal supra-glottic partial laryngectomy (horizontal group) and 17 patients with supra-cricoid partial laryngectomy (SCPL group) . This study observed the time of gastric tube extubation of patients, video-fluoroscopic swallowing study (VFSS) 15 days after surgery, score of Modified Penetration Aspiration Scale (MPAS) and scores of Gugging Swallowing Screen (GUSS) 15, 20 and 30 days after surgery, and compared the swallowing function of patients among three groups.Results:There were statistical differences in the time of gastric tube extubation, scores of GUSS and VFSS+MPAS 15 days after surgery among three groups ( P<0.01) . When taking time as main effect, the Roy maximum root test displayed F=460.693, P<0.001 which showed that time had influence on the score of GUSS; when taking surgery as the main effect, the Roy maximum root test displayed F=218.387, P<0.001 which showed that surgery type had influence on the score of GUSS. There were statistical differences in the development trends of swallowing at different times among three surgery types when time interacted with the surgery type ( F=164.033, P<0.001) . Conclusions:The vertical partial laryngectomy has the small impact on swallowing function and patients recovery quickly. However, horizontal supra-glottic partial laryngectomy and SCPL have great impact on swallowing function; swallowing function can't be well compensated by sphincter function of remnant larynx in a short time; besides, patients with horizontal supra-glottic partial laryngectomy need a long rehabilitation period.