口含冰对恶性肿瘤患者头颈部放疗后防治口腔黏膜炎的临床研究

目的探讨口含冰防治恶性肿瘤患者头颈部放疗(以下简称头颈部放疗)后所致口腔黏膜炎的效果。方法将68例放疗患者分为对照组(35例)和实验组(33例)。对照组在整个放疗期间进行常规口腔护理,实验组除常规口腔护理外,从放疗开始每天于放疗后预防性予口含冰:即口含生理盐水冻制而成的2 cm×2 cm×2 cm大小的冰块。每天含两次,每次连续含冰约6～8块,持续约30 min,两次间隔30 min,至放疗结束。结果首次放疗至30 Gy时及剂量大于30 Gy至放疗结束时,两组疗效比较差异有显著意义(P0.05)。实验组较对照组口腔黏膜炎的发生率降低,重度发生例数减少;实验组有两例患者由重度转化为轻度,且未发生不良反应;首次发生口腔黏膜炎的平均时间实验组也较对照组延迟1周左右。结论口含冰可用于防治放疗后发生放射性口腔黏膜炎,降低发生率,减轻黏膜炎严重程度,延迟其发生时间,延缓其进展。

Clinical study for the prevention and treatment of radioactive oral mucositis for patients with carcinoma after radiotherapy in head and neck by oral ice holding

Objective To study the effect of oral ice holding for prevention and treatment of radioactive oral mucositis for patients with carcinoma after radiotherapy in head and neck. Method 68 patients with radiotherapy in head and neck were enrolled and randomly divided into treatment group（33 cases） and control group（35cases）.All of the patients accepted conventional oral care after radiotherapy daily.Besides routine treatment,patients in treatment group hold the ice in the mouth after radiotherapy daily up to finish radiotherapy.Oral ice holding means keep the ice which volume is 2cm×2cm×2cm,colded by saline in the mouth daily,for twice each day and 30-minute for each,by 30-minute interval.An objective mucositis assessment tool was used daily to document the change of oral mucosa.Mucositis were diagnosed and evaluated according to the RTOG toxicity criteria.Result There was significant difference between two groups when total doses is up to 30 Gy（P0.05） and total doses of finished radiotherapy is more than 30 Gy（P0.05）.The incidence of oral mucositis in treatment group is lower than that of the control group.The patients with severe mucositis（grade 3-4 adverse） in treatment group was less than that of control group when finished radiotherapy.Two severe patients were cured.And all of the patients have no adverse reactions.The time of the first appearance in different level oral mucositis in treatment group was postponed for about one week.Conclusion Holding the ice in the mouth after radiotherapy were effective to prevent and treat acute radioactive oral mucositis for patients with carcinoma,which will reduce the severity of mucositis,delay its time of occurrence and its progress