不同雾化方式在鼻咽癌调强放疗口腔黏膜反应中的应用效果

目的 探讨治疗鼻咽癌调强放疗黏膜反应更好的雾化方法,缓解因黏膜反应给患者带来进食困难及口腔疼痛等方面的问题.方法 选取2012年6月至2014年12月符合条件60例鼻咽癌调强放疗引起黏膜反应患者,随机分为观察组和对照组各30例.观察组采用超声雾化吸入方式治疗,药物:生理盐水20 ml、地塞米松5 mg、庆大霉素8万U;对照组采用氧动力雾化吸入方式治疗,药物:生理盐水6 ml、地塞米松5 mg、庆大霉素8万U.两组每日8:00~12:00、15:30~17:30进行雾化吸入,观察两组患者雾化后3 d、5 d、7 d黏膜反应的治疗效果以及雾化时、雾化后30 min、1 h口咽舒适变化.结果 观察组雾化5 d后有效减轻口咽黏膜反应程度,与对照组比较疗效有差异(P<0.05);观察组雾化时、雾化后30 min口咽干燥、疼痛缓解明显低于对照组,疗效满意,雾化后1 h口咽疼痛优于对照组(P<0.05).结论 超声雾化吸入方式有利于改善鼻咽癌调强放疗患者的口干、口腔咽喉疼痛等不适症状,提高患者的舒适度,更适合鼻咽癌调强放疗患者黏膜反应治疗.

Application effect of different atomization treatment methods on relieving oral mu-cosa reaction caused by intensity-modulated radiotherapy for nasopharyngeal carci-noma

Objective To find out a better atomization treatment method to counter oral mucosa changes dur-ing the intensity modulated radiation therapy ( IMRT) process of nasopharyngeal cancer, so as to relieve oral pains and eliminate dining problems which are caused by oral mucosa changes. Methods Over the period from June 2012 to De-cember 2014 , a total of 60 nasopharyngeal cancer patients who suffered oral mucosa changes caused by IMRT were se-lected and divided into an observation group (30 patients) and a control group (30 patients) . Patients in the observa-tion group were treated with ultrasonic atomizing inhalation method. Such treatment needs normal saline of 20 ml, dexa-methasone of 5 mg, and gentamycin of 80 thousand U. The other in the control group was treated with oxygen dynamic atomizing inhalation method. Such treatment needs normal saline of 6 ml, dexamethasone of 5 mg, and gentamycin of 80 thousand U. Patients in these two groups were subject to atomizing inhalation treatment every day from 8: 00 to 12: 00 and from 15: 30 to 17: 30. The oral mucosa changes after 3 days', 5 days' and 7 days' atomizing inhalation treatment were observed. In addition, the changes of oropharyngeal comfort in the atomizing process, after 30 minutes' atomizing, and after 1 hour's atomizing were also observed. Results After 5 days of atomizing inhalation treatment, oral mucosa changes of the observation group were greatly relieved. This was different from the treatment effect of the control group. Oropharyngeal dryness and pains of the observation group were less serious than that of the control group after 30 minutes' atomizing treatment, or even in the atomizing process, P<0. 05. After 1 hour's treatment, oropharyngeal pains were greatly relieved than that of the control group. This demonstrated satisfactory treatment effect, P<0. 05. Conclu-sion Ultrasonic atomizing inhalation method can effectively improve oral dryness, oral pains, and sore throats of naso-pharyngeal cancer patients, making them feel more comfortable. This method is more suitable for treatment of oral muco-sa changes during the IMRT process of nasopharyngeal cancer.