口腔癌术后言语功能影响因素分析

doi:10.7518/gjkq.2025005

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (1): 42-49.doi: 10.7518/gjkq.2025005

口腔癌术后言语功能影响因素分析

吴媚¹(),梁妍景¹,彭雪沛²,陈卫宏²,郭星铜²,侯黎莉³()

^1.上海交通大学护理学院上海 200025
^2.成都中医药大学护理学院成都 610075
^3.上海交通大学医学院附属第九人民医院护理部上海 200011

收稿日期:2024-02-04 修回日期:2024-08-06 出版日期:2025-01-01 发布日期:2025-01-11
通讯作者: 侯黎莉
作者简介:吴媚，硕士，Email：<email>583512378@qq.com</email>
基金资助:
上海申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22023238)

Current status of speech function after oral cancer surgery and analysis of influencing factors

Mei Wu¹(),Yanjing Liang¹,Xuepei Peng²,Weihong Chen²,Xingtong Guo²,Lili Hou³()

^1.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
^2.School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
^3.Dept. of Nursing, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2024-02-04 Revised:2024-08-06 Online:2025-01-01 Published:2025-01-11
Contact: Lili Hou
Supported by:
Shanghai Shenkang Hospital Development Center Municipal Hospital Diagnosis and Treatment Technology Promotion and Optimization Management Project(SHDC22023238)

摘要/Abstract

摘要：

目的了解口腔癌术后患者言语功能的现况并分析影响术后言语功能的因素。方法 2021年12月31日—2023年3月31日于上海交通大学医学院附属第九人民医院就诊且符合纳入标准的180名患者为研究对象，采用一般信息及临床资料调查表、言语障碍指数量表（SHI）、语音清晰度字表、医院焦虑抑郁情绪量表（HADS）、家庭关怀指数（FAI）问卷、社会支持评定量表（SSRS）进行调查分析。结果口腔癌术后存在言语障碍的比例为70%，语音清晰度降低的比例为61%。通过逐步线性回归分析结果显示：医院焦虑抑郁情绪抑郁分量表（HADS-D，P=0.009）、FAI（P=0.004）、SSRS（P=0.039）及放射治疗（P=0.019）变量进入回归方程，是影响口腔癌术后SHI的主要因素（63.8%）；T分期（P=0.001）、收入（P=0.007）、饮酒（P=0.001）、肿瘤部位（P=0.001）及SSRS变量（P=0.013）进入回归方程，是影响口腔癌术后语音清晰度的主要因素（55.3%）。结论超过半数的口腔癌术后患者存在不同程度的言语功能受损，应从影响言语功能的主观因素及客观因素两个方面对患者进行早期预防、早期评估和早期干预。

关键词: 口腔癌, 术后, 言语功能, 现况调查, 影响因素

Abstract:

Objective This study aims to explore the development trends, research hotspots, and future directions of smart healthcare for oral cancer through bibliometrics, providing a reference for subsequent research. Methods English literature on smart healthcare for oral cancer in Web of Science Core Collection, Scopus, and PubMed databases and Chinese literature on the same topic in the CNKI database published in 2003-2023 were retrospectively collected. Meanwhile, the evidence-based visualization and comparative analysis of the countries, institutions, authors, citation frequency, and keywords included in the literature were performed with VOSviewer 1.6.18 software. Results A total of 547 English articles and 34 Chinese documents were included. An increasing trend in publication volume, especially in recent years, was observed. Among countries, the United States was the largest contributor to the field and had close academic exchanges with other countries, whereas cross-border, cross-institutional, and cross-team cooperation was limited in China. Moreover, network structure had regional characteri-stics. In addition, the artificial intelligence-assisted diagnosis and treatment of oral cancer are a common focus of attention in domestic and foreign literature. English literature focuses on the deep exploration of new diagnostic technologies, whereas Chinese literature tends to explore the application of intelligent health care and traditional Chinese medicine network pharmacology. Conclusion The conti-nuous development of smart healthcare for oral cancer has made the research on its application in artificial intelligence-assisted diagnosis, intelligent health care, and traditional Chinese medicine pharmacology increasingly profound. Early warning screening urgently needs to become an important focus of smart healthcare for oral health.Objective　This study aimed to investigate the status of speech function in postoperative patients with oral cancer and analyze the factors affecting speech function. Methods　A total of 180 patients who were admitted Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from December 31, 2021 to March 31, 2023 and met the inclusion criteria were selected as the study subjects. The general information and clinical data questionnaire, Speech Handicap Index (SHI), Speech Articulation Word Scale, Hospital Anxiety and Depression Scale (HADS), Family Apgar Index (FAI), and Social Support Rating Scale (SSRS) were used. Results　After oral cancer surgery, the proportion of speech disorder was 70%, and the proportion of speech articulation decreased by 61%. The results of step-by-step linear regression analysis showed that the Hospital Anxiety and Depression Scale-Depression (HADS-D; P=0.009), FAI (P=0.004), SSRS (P=0.039), and radiotherapy (P=0.019) scores entered the regression equation. The total variation in SHI score after oral cancer surgery was explained by 63.8%. T stage (P=0.001), income (P=0.007), alcohol consumption (P=0.001), tumor site (P=0.001), and SSRS (P=0.013) were included in the regression equation, accounting for 55.3% of the total variation in speech articulation after oral cancer surgery.Conclusion　More than half of the patients with postoperative oral cancer have different degrees of impaired speech function, and early prevention, assessment, and intervention for patients should be performed with subjective and objective factors.

Key words: oral cancer, postoperative, speech function, status survey, influencing factors

中图分类号:

R730.7

吴媚, 梁妍景, 彭雪沛, 陈卫宏, 郭星铜, 侯黎莉. 口腔癌术后言语功能影响因素分析[J]. 国际口腔医学杂志, 2025, 52(1): 42-49.

Mei Wu, Yanjing Liang, Xuepei Peng, Weihong Chen, Xingtong Guo, Lili Hou. Current status of speech function after oral cancer surgery and analysis of influencing factors[J]. Int J Stomatol, 2025, 52(1): 42-49.

图/表 5

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变量	构成/n（%）
性别
男	128（71）
女	52（29）
年龄/岁
<60	144（80）
≥60	36（20）
工作
在职	120（67）
无业	60（33）
教育程度
中学或以下	27（15）
高中或中专	120（67）
大学及以上	33（18）
收入/（元/月）
<5 000	79（44）
≥5 000	101（56）
婚姻
单身/离异/丧偶	8（4）
已婚/复婚	172（96）
吸烟
是	77（43）
否	103（57）
饮酒
是	65（36）
否	115（64）
T分期
1~2	106（59）
3~4	55（31）
远处转移
是	16（9）
否	164（91）
肿瘤部位
舌体	86（48）
舌根	29（16）
颊部	14（8）
牙龈	29（16）
硬腭	5（3）
口底	14（8）
唇	3（1）
复发
是	16（9）
否	164（91）
术后时间/月
3~6	32（18）
6~12	63（35）
>12	85（47）
皮瓣
是	115（64）
否	65（36）
术后牙缺损
是	58（32）
否	122（68）
舌缺损范围
半舌	84（56）
全舌	18（12）
无	48（32）
张口度
正常/Ⅰ	161（89）
Ⅱ/Ⅲ	19（11）
放射治疗
是	110（61）
否	70（39）

变量	SHI得分				语音清晰度
变量	均值	标准差	F值/t值	P值	均值	标准差	F值/t值	P值
性别
男	25.49	25.63	-0.010	0.889	0.80	0.28	-0.116	0.170
女	26.00	25.55			0.81	0.24
年龄/岁
<60	25.80	25.17	0.150	0.779	0.82	0.25	1.070	0.015
≥60	25.00	27.32			0.76	0.33
工作
在职	26.00	23.73	0.030	0.970	0.83	0.24	1.661	0.194
无业	24.92	30.88			0.82	0.27
教育程度
中学或以下	22.54	25.71	1.736	0.180	0.89	0.18	7.853	0.001
高中或中专	28.26	27.11			0.75	0.30
大学及以上	18.71	17.41			0.95	0.08
收入/（元/月）
<5 000	27.63	28.29	0.848	0.053	0.74	0.29	-2.873	0.003
≥5 000	24.07	23.18			0.86	0.23
婚姻
单身/离异 /丧偶	43.50	28.13	2.056	0.844	0.72	0.21	-0.932	0.397
已婚/复婚	24.63	25.11			0.81	0.27
吸烟
是	26.09	26.14	0.187	0.408	0.79	0.27	-0.592	0.316
否	25.30	25.22			0.82	0.26
饮酒
是	28.30	26.06	0.955	0.151	0.75	0.30	-2.077	0.028
否	24.15	25.24			0.84	0.24
T 分期
1~2	14.20	15.17	9.152	<0.001	0.98	0.03	9.417	<0.001
3~4	32.00	26.08			0.63	0.31
远处转移
是	54.43	33.34	4.441	0.037	0.60	0.36	-3.070	0.001
否	22.68	22.75			0.83	0.25
肿瘤部位
舌体	22.22	22.24	2.877	0.011	0.87	0.15	2.903	0.013
舌根	42.67	28.37			0.67	0.37
颊部	16.00	22.00			0.92	0.10
牙龈	19.67	26.70			0.79	0.35
硬腭	35.00	18.48			0.60	0.42
口底	24.83	27.36			0.72	0.36
唇	36.50	33.23			0.78	0
复发
是	51.07	35.06	4.201	0.001	0.60	0.36	-3.070	0.001
否	22.68	22.75			0.83	0.25
术后时间/月
3~6	21.21	21.33	0.548	0.579	0.87	0.22	1.084	0.341
6~12	25.08	24.13			0.78	0.29
>12	27.16	27.82			0.8	0.26
皮瓣
是	29.22	25.25	2.549	0.261	0.78	0.26	-1.627	0.804
否	18.41	24.36			0.85	0.27
术后牙缺损
是	20.38	24.29	-1.648	0.101	0.78	0.31	-0.950	0.010
否	27.66	25.68			0.82	0.24
舌缺损范围
半舌	23.81	22.98	3.941	0.022	0.85	0.21	5.809	0.004
全舌	40.67	30.38			0.62	0.32
无	22.23	25.96			0.79	0.31
张口度
正常/Ⅰ	24.47	25.69	2.558	0.057	0.82	0.26	1.232	0.300
Ⅱ/Ⅲ	38.23	17.83			0.73	0.31
放射治疗
是	32.61	26.129	4.730	<0.001	0.74	0.29	-4.036	<0.001
否	13.78	19.345			0.91	0.17

测量项目	均值	标准差	SHI	语音清晰度
SHI	25.330	25.390	1	-0.646**
语音清晰度	0.810	0.267	-0.646**	1
HADS	7.060	6.890	0.708**	-0.508**
HADS-A	2.710	2.860	0.718**	-0.540**
HADS-D	4.350	4.240	0.665**	-0.460**
FAI	8.090	2.150	-0.370**	0.184*
SSRS	38.070	6.990	-0.473**	0.404**

变量	B值	SE值	Beta值	t值	P值	共线性统计
变量	B值	SE值	Beta值	t值	P值	容忍度	方差膨胀因子
HADS-D	1.702	0.662	0.171	2.060	0.009	0.199	5.032
FAI	-1.784	0.612	-0.151	-2.915	0.004	0.903	1.107
SSRS	2.180	1.047	0.185	2.082	0.039	0.281	3.554
放射治疗	-6.466	2.719	-0.124	-2.378	0.019	0.887	1.127

变量	B值	SE值	Beta值	t值	P值	共线性统计
变量	B值	SE值	Beta值	t值	P值	容忍度	方差膨胀因子
T分期	-0.050	0.014	-0.218	-3.528	0.001	0.789	1.268
饮酒	0.108	0.031	0.195	3.445	0.001	0.940	1.064
SSRS	0.006	0.002	0.158	2.517	0.013	0.763	1.310
肿瘤部位	-0.030	0.009	-0.194	-3.275	0.001	0.857	1.166

口腔癌术后言语功能影响因素分析

Current status of speech function after oral cancer surgery and analysis of influencing factors

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