目的 探索改良阶段式吞咽训练在喉切除术后患者中的应用效果。 方法 2021年3月至2022年10月，采用便利抽样法选取在安徽省某三级甲等医院耳鼻喉科首次行喉切除的140例喉癌患者为研究对象，将2021年3-12月收治的60例患者作为对照组，接受常规吞咽训练；2022年1-10月收治80例患者作为观察组，接受改良阶段式吞咽训练。采用洼田饮水试验（water swallow test，WST）、进食评估问卷调查表（eating assessment tool-10，EAT-10）、安德森吞咽困难量表（M.D.Anderson dysphagia inventory，MDADI）、经口摄食吞咽功能评价量表（functional oral intake scale，FOIS）对两组患者术后的吞咽功能进行评价和比较。 结果 术后7、30和90 d，观察组患者的WST及EAT-10异常例数均少于对照组，MDADI及FOIS评分均高于对照组，差异均有统计学意义（P＜0.05或P＜0.01）； 观察组患者留置胃管天数和住院费用均少于对照组，差异均有统计学意义（均P＜0.01）。 结论 改良阶段式吞咽训练能够有效改善喉切除术后患者的吞咽功能，提高生活质量，缩短留置胃管天数，降低住院费用。

Objective To explore the effects of modified stage swallowing training in patients after laryngectomy. Methods From March 2021 to October 2022，140 patients with laryngeal cancer who underwent laryngectomy for the first time at the Department of Otolaryngology of a tertiary A hospital in Anhui Province were selected by convenience sampling method. The cases were divided into two groups. The control group (n=60)，which included sixty patients admitted from March to December 2021，received routine swallowing training，while the experimental group (n=80)，which included eighty patients admitted from January to October 2022，received improved stage swallowing training. Water swallow test (WST)，eating assessment tool-10 (EAT-10)，M.D. Anderson dysphagia inventory (MDADI)，and functional oral intake scale (FOIS) were used to evaluate and compare the postoperative swallowing function of the two groups. Results At 7，30 and 90 days after surgery，the number of abnormal WST and EAT-10 cases in experimental group was lower than that in control group，and MDADI and FOIS scores were higher than those in control group，with statistical significance (P＜0.05 or P＜0.01). The days and hospitalization cost of patients in observation group were less than those in control group，and the differences were statistically significant (all P＜0.01). The duration of gastric tube indwelling in the experimental group was shorter than that in the control group，and the hospitalization cost was lower than that in the control group (all P＜0.01). Conclusions Modified stage swallowing training can effectively improve the swallowing function，improve the quality of life，shorten the days of an indenturing gastric tube，and reduce the cost of hospitalization，which is worthy of clinical promotion.

R473.76