循证护理在放射性口腔黏膜炎患者中的应用

目的 探讨放射性口腔黏膜炎的防治护理方法.方法 将60例头颈部肿瘤放疗患者随机分为常规组和循证组各30例.常规组采用传统护理方法,循证组运用循证护理的方法采取早期防范性护理干预及对症护理.结果 循证组口腔黏膜反应及疼痛程度减轻,有显著性差异(P＜0.05).结论 应用循证护理理论指导临床实践,为患者实施最佳的护理决策,有效减轻了口腔黏膜反应及疼痛程度,取得较好治疗效果.     

癌症患者口腔黏膜炎评估的最佳实践

本“最佳实践信息手册”的信息来源于2010－2013年发表的3篇系统评价［1‐3］，这3篇系统评价中1篇是由英国 Faith Gibson等人组成的团队进行，另外2篇是由英国T he Cochrane Collaboration团队撰写，分别可以从 Wolters Kluwer Health／Lippincott Williams & Wilkins 及 The Cochrane Library获得全文。     

循证护理在预防放化疗病人口腔黏膜炎中应用效果的Meta分析

目的:系统评价循证护理在放化疗病人口腔黏膜炎预防中的应用效果.方法:系统检索万方数据库、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、Cochrane Library、PubMed、Embase,检索时限均为建库起至2019年11月,收集有关循证护理在预防放化疗病人口腔黏膜炎中效果的随机对照试验,对符合纳入标准的临床研究进行资料提取,采用RevMan 5.3软件进行Meta分析.结果:共纳入14篇文献,合计1611例病人.Meta分析结果显示,循证护理组与常规护理组口腔黏膜炎总发生率[OR=0.33,95％CI(0.26,0.43),P<0.00001]、严重口腔黏膜炎发生率[OR=0.17,95％CI(0.10,0.27),P<0.00001]及护理满意度[OR=11.74,95％CI(3.50,39.43),P<0.0001]比较差异均有统计学意义.结论:循证护理可降低放化疗病人口腔黏膜炎的发生率,减轻口腔黏膜炎的严重程度,提高护理满意度.     

循证护理在预防放化疗病人口腔黏膜炎中应用效果的Meta分析

目的:系统评价循证护理在放化疗病人口腔黏膜炎预防中的应用效果.方法:系统检索万方数据库、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、Cochrane Library、PubMed、Embase,检索时限均为建库起至2019年11月,收集有关循证护理在预防放化疗病人口腔黏膜炎中效果的随机对照试验,对符合纳入标准的临床研究进行资料提取,采用RevMan 5.3软件进行Meta分析.结果:共纳入14篇文献,合计1611例病人.Meta分析结果显示,循证护理组与常规护理组口腔黏膜炎总发生率[OR=0.33,95％CI(0.26,0.43),P<0.00001]、严重口腔黏膜炎发生率[OR=0.17,95％CI(0.10,0.27),P<0.00001]及护理满意度[OR=11.74,95％CI(3.50,39.43),P<0.0001]比较差异均有统计学意义.结论:循证护理可降低放化疗病人口腔黏膜炎的发生率,减轻口腔黏膜炎的严重程度,提高护理满意度.     

循证护理在防治大剂量甲氨蝶呤所致口腔黏膜炎中的应用

口腔黏膜炎是大剂量甲氨蝶呤化疗后常见而严重的并发症之一。应用循证护理对32例大剂量甲氨蝶呤化疗的血液病患者实施预防和护理,患者口腔黏膜炎的发生率仅为12．5％,低于文献报道的20％-25％。     

循证护理的理论与实践

患者,男性,42岁。半年前发现回吸涕带血,继而伴发耳鸣、吞咽困难,经病理确诊为鼻咽低分化鳞癌。采用60Co～7线放射治疗,以耳颈联合野为主照射,辅以其它野,5次／周,2GY／次,在剂量达36～40GY／18～20次时缩野继续放疗至肿瘤根治量60～70GY／30～35次。     

集束化护理在日间病房头颈部肿瘤放疗患者口腔黏膜炎防治中的应用

目的探讨集束化护理在日间病房头颈部肿瘤放疗患者口腔黏膜炎防治中的应用效果。方法选取2015年7月~12月我科收治的21例头颈部肿瘤患者作为对照组。2016年1月~6月我科收治的21例头颈部肿瘤患者作为干预组。干预组采取集束化护理。对照组采取常规护理。比较两组住院时间、住院费用、患者满意度及口腔黏膜炎发生率。结果干预组住院时间、住院费用及口腔黏膜炎发生率均低于对照组,患者满意度高于对照组,差异有统计学意义(P<0.05)。结论实施集束化护理可降低患者住院时间及住院费用,降低患者口腔黏膜炎发生率,提高患者满意度,具有重要的临床应用价值。     

癌症放化疗患者口腔黏膜炎的护理进展

文章归纳了常用的口腔黏膜评估工具,并从口腔护理、口腔冷疗、心理干预、疼痛控制方面综述了口腔黏膜炎的护理进展。在此基础上,对未来研究方向进行展望,旨在为护士在临床工作中选择适宜的评估工具及护理干预措施提供参考,以有效防治口腔黏膜炎,提高患者的生存质量。     

口腔冷疗预防放化疗所致口腔黏膜炎研究现状

综述了口腔冷疗预防放化疗所致口腔黏膜炎研究现状,指出应对口腔冷疗方法、时间及应用范围进行进一步深入分析,以更好地发挥口腔冷疗对放化疗所致口腔黏膜炎的预防作用。     

Current practices for management of oral mucositis in cancer patients

Many anticancer therapies induce oral mucositis, diminishing the patient's quality of life. Especially in neutropenic patients, it can lead to life-threatening systemic infection. Moreover, it can become a limiting factor in intensive treatment schedules. Many interventions are aimed at reducing trauma and the risk of secondary infection. The institution of good oral hygiene seems to play a crucial part and can be achieved manually or by means of antiseptic agents. More specific antimicrobial therapy may be indicated. In addition, local and/or systemic pain control may be required. The administration of hematological growth factors, cryoprotectants and other agents or measures that may be of help in the management of mucositis are discussed. Electronic publication: 14 December 1998     

Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy

Goal of work The aim of the study is to evaluate the effect of fluconazole antifungal prophylaxis on the severity of mucositis in head and neck cancer patients receiving radiotherapy.Patients and methods Sixty-three patients, with malignant head and neck tumor, eligible to receive radiotherapy, entered the study. Thirty-four patients (group A) received 100 mg/day of fluconazole prophylaxis during radiotherapy and were compared with 29 patients, who received radiotherapy alone (group B). The two groups were similar in terms of patients and radiotherapy characteristics. Smear to test for Candida carriage was taken before and after radiotherapy. Oral candidiasis was diagnosed using the criteria described before. Oral mucositis was recorded according to EORTC/RTOG criteria.Main results A significant reduction of severe mucositis at the end of radiotherapy (14.7 vs 44.8%, p=0.018) and of interruptions (0 vs 17.2%, p=0.017) was observed in group A. Candidiasis was prevented (0 vs 34.5%, p=0.001), with a significant reduction of Candida carriage of 40.7% (p=0.001).Conclusion Fluconazole prophylaxis showed a significant beneficial impact on the severity of mucositis and on radiotherapy interruptions in this group of patients. The current study provides data on the build of a randomized controlled trial on the effect of fluconazole prophylaxis on treatment schedule and quality of life of the patients during head and neck radiotherapy.     

放化疗致口腔黏膜炎病人生活质量及其影响因素研究

目的 了解放化疗性口腔黏膜炎患者的生活质量水平及其影响因素。方法 采用描述性研究方法对南通市3家综合性医院220例放化疗致口腔黏膜炎的患者进行问卷调查。自行设计一般问卷和口腔黏膜炎患者生活质量特异性量表,应用统计描述、方差分析、t检验、多元逐步回归方法分析放化疗性口腔黏膜炎患者的生活质量及其影响因素。结果 调查220例,回收有效问卷205例。205例放化疗性口腔黏膜炎的患者的生活质量总得分（100.30±22.16）分;单因素分析显示年龄、文化程度、家庭月收入、治疗方法是患者生活质量的影响因素(P<0.05)。结论 放化疗性口腔黏膜炎患者的生活质量较低,影响口腔黏膜炎患者生活质量的因素较多。     

预防放射性口腔黏膜反应方法的探讨

目的 探讨预防头颈部肿瘤患者放疗所致口腔黏膜反应的有效方法.方法 将92例头颈部肿瘤放疗患者随机分为A组31例,B组31例,C组30例.A组每次放疗前、后1 h给鱼腥草注射液20 ml+丹参注射液加20ml+蒸馏水30 ml雾化吸入,20 min/次,至放疗结束.B组给予康复新注射液2 ml+维生素B12注射液0.5 mg+生理盐水50 ml雾化吸入,方法同A组.C组采用中草药养阴清肺汤方剂水煎取汁500 ml,分别在放疗前、后1 h各服一半,至放疗结束.比较3组口腔黏膜反应的发生情况.结果 A组患者Ⅱ级、Ⅲ级口腔黏膜反应发生率及严重程度均明显低于B、C组.结论 鱼腥草、丹参注射液合剂雾化吸人预防放射性口腔黏膜反应的临床效果显著.     

预防放射性口腔黏膜反应方法的探讨

目的探讨预防头颈部肿瘤患者放疗所致口腔黏膜反应的有效方法。方法将92例头颈部肿瘤放疗患者随机分为A组31例,B组31例,C组30例。A组每次放疗前、后1h给鱼腥草注射液20ml＋丹参注射液20ml＋蒸馏水30ml雾化吸入,20min／次,至放疗结束。B组给予康复新注射液2ml＋维生素B12注射液0．5mg＋生理盐水50ml雾化吸入,方法同A组。C组采用中草药养阴清肺汤方剂水煎取汁500ml,分别在放疗前、后1h各服一半,至放疗结束。比较3组口腔黏膜反应的发生情况。结果A组患者Ⅱ级、Ⅲ级口腔黏膜反应发生率及严重程度均明显低于B、C组。结论鱼腥草、丹参注射液合剂雾化吸入预防放射性口腔黏膜反应的临床效果显著。     

头皮式静脉留置针使用中的护理干预

静脉留置针具有操作简单，套管柔软，在静脉内留置时间长，且不易穿破血管等优点，现已广泛应用于临床。静脉留置针的应用可减少静脉穿刺次数，减轻患者痛苦，保护穿刺静脉，而且提高了护士工作效率，有利于临床用药和紧急抢救。但临床常因留置针护理不当带来的并发症而未达到留置预期时间，患者感觉得不偿失。为此，2005年6月-2006年9月，本研究对初次行浅静脉留置穿刺的患者进行了护理干预，现报道如下。     

解毒愈疡漱口方用于防治急性白血病化疗相关口腔黏膜炎的研究

[目的]探讨解毒愈疡漱口方对急性白血病化疗并发口腔黏膜炎的临床疗效。[方法]随机入组90例急性白血病接受联合化疗患者,治疗组45例,予解毒愈疡漱口方漱口；对照组给45例,予康复新液漱口。观察治疗组与对照组在化疗第5天、第10天的口腔黏膜炎疗效,以及对血常规、肝肾功能的影响。[结果]化疗第5天治疗组与对照组口腔黏膜炎发生率及严重程度无明显统计学差异,而化疗第10天治疗组较对照组口腔黏膜炎程度及疼痛程度明显减轻,具有统计学差异(p＜0.05)。两组血常规、肝肾功能无统计学差异(p＞0.05)。[结论]中药解毒愈疡漱口方含服漱口对防治口腔黏膜炎有效率、创面愈合率疗效显著,且消肿止痛效果明显,大大提高了病人的舒适度及满意度。     

Herpes simplex virus-1 (HSV-1) infection in radiation-induced oral mucositis

Goal of work The aim of the study was to investigate the incidence of herpes simplex virus-1 (HSV-1) infection in mucositis during head and neck cancer radiotherapy.Patients and methods Sixty patients with malignant head and neck tumor, eligible to receive radiotherapy, who were referred to the Dental Oncology Unit, entered the study. Sixteen patients (26.6%) received concomitant chemotherapy. Mucositis was recorded weekly. Smears taken from the ulcers of mucositis grade 2, or 3, or 4 were stained with Papanicolaou and alkaline phosphatase/antialkaline phosphatase immunocytochemical method to identify HSV-1.Main results Forty-eight of all 60 patients developed ulcerative mucositis. Smear was available from 29 of 48 patients with ulcerations. HSV-1 infection was identified in 14 of 29 smears available (48.2%). Mucositis healed or was reduced after 1 week of antiviral treatment in 11 of those 14 HSV-1-positive patients; 3 patients responded to 1 g/day of valacyclovir, 7–2 g/day, and 1 patient responded to i.v. acyclovir. Ulcerations recurred after quitting antivirals. Three patients did not respond to 1 g/day of valacyclovir. No HSV-1-negative patient responded to acyclovir (P=0.000).Conclusion HSV-1 was isolated from 14 of 29 available smears taken from 48 patients with ulcerative mucositis. The incidence of HSV-1 infection during radiotherapy was estimated as being 14 of all 48 patients at risk (29.1%). Healing or reduction in the grade of mucositis after antivirals in HSV-1 positive patients, combined with the negative response to antivirals in HSV-1 negative patients, denoted that HSV-1 infection was a component of ulcerative radiation mucositis in those HSV-1-positive patients.