Abstract: Objective To observe the correlation between dysphagia and early prognosis of patients with oral cancer through the evaluation of dysphagia. Methods Totally 124 patients with oral cancer were selected，and the patients were evaluated by water swallow test and examined by videofluoroscopic swallowing study（VFSS）after operation and oral prosthodontic treatment，and the effects of two methods were compared. In a period of 3 months，95 cases were successfully followed up. According to whether the patient was able to eat completely by mouth，the patients were divided into good prognosis group（64 cases）and poor prognosis group（31 cases）. VFSS was used to record the relevant observation indexes，and Logistic regression was used to analyze the correlations between VFSS parameters and the prognosis of early dysphagia. Results The consistency between the water swallow test and VFSS test was high（Kappa = 0.710，P < 0.05）. The oral delivery time，pharyngeal delay time and pharyngeal delivery time detected by 3mL liquid，10mL semisolid and 10cm3 solid in the poor prognosis group were longer than those in the good prognosis group（P < 0.05）. The upward ranges of hyoid detected by 3mL liquid and 10mL semisolid in the poor prognosis group were greater than those in the good prognosis group（P < 0.05）. Logistic regression analysis showed that the oral delivery time，pharyngeal delay time and pharyngeal delivery time detected by 3mL liquid were related to the poor prognosis of dysphagia（OR = 1.466，1.743，4.315；P = 0.011，0.030，0.003）. Conclusion VFSS is an effective method to observe whether oral cancer patients have dysphagia. VFSS-related parameters of oral cancer patients after surgery are related to the poor prognosis of early dysphagia，such as the oral delivery time，pharyngeal delay time and pharyngeal delivery time detected by 3mL liquid.

Key words: oral cancer, dysphagia, prognosis

摘要： 目的 通过对口腔癌患者术后吞咽障碍的评价，观察其与口腔癌患者早期吞咽障碍预后的相关性。方法 选取2016年9月至2019年9月于辽宁中医药大学附属医院确诊并手术治疗的口腔癌患者124例，经口腔修复后进行洼田饮水试验评估及电视X线透视吞咽功能（VFSS）检查，比较两种方法评价吞咽障碍效果。根据成功随访3个月的95例患者是否能够完全经口进食，将患者分为预后良好组（64例）和预后不良组（31例）。通过VFSS检查记录相关观察指标，采用Logistics回归分析各VFSS参数与早期吞咽障碍预后的相关性。结果 洼田饮水试验与VFSS检查检测效能比较，一致性较高（Kappa = 0.710，P < 0.05）。预后不良组患者3 mL液体、10 mL半固体、10 cm3固体检测口腔传送时间、咽延迟时间、咽传送时间均长于预后良好组（P < 0.05）；预后不良组患者3 mL液体、10 mL半固体检测舌骨上抬幅度大于预后良好组（P < 0.05）。Logistic回归分析结果显示，3 mL液体口腔传送时间、咽延迟时间、咽传送时间（OR值分别为1.466、1.743、4.315，P值分别为0.011、0.030、0.003）与吞咽障碍预后不良有关。结论 VFSS是观察口腔癌患者是否发生吞咽障碍的有效方法。口腔癌患者术后VFSS相关参数（如3 mL液体口腔传送时间、咽延迟时间、咽传送时间）与其早期吞咽障碍预后不良相关。

关键词: 口腔癌, 吞咽障碍, 预后