金因肽防治鼻咽癌放疗后口腔黏膜反应疗效观察

目的 观察金因肽喷雾剂对防治鼻咽癌放疗后所致口腔黏膜反应的疗效.方法 将经过病理学检查确诊为鼻咽癌并接受放疗的初治患者80例,随机分为观察组和对照组各40例.观察组采用金因肽喷雾剂含漱,对照组采用庆大霉素漱口液含漱.在放疗第7周末观察两组病例口腔黏膜反应情况.结果 放疗第7周末观察组全部顺利完成放疗,对照组有4例停止放疗;观察组患者放射性黏膜反应明显低于对照组(P<0.01).结论 金因肽喷雾剂能减轻放射性黏膜反应,减轻患者痛苦.     

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。     

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.     

康复新液在防治鼻咽癌放射性口腔黏膜反应中的效果观察

目的：观察康复新液防治鼻咽癌患者放射治疗所致口腔黏膜反应的效果。方法将134例鼻咽癌行放射治疗的患者随机分为实验组和对照组各67例。2组均进行常规护理,实验组在整个放射治疗期间均于三餐后用康复新液含漱2～3 m in。结果在放射治疗第3周、第6周末和放射治疗结束后1周,实验组口腔黏膜反应程度明显低于对照组。结论康复新液可有效防治放射性口腔黏膜反应并促进口腔溃疡愈合。     

放射性口腔黏膜反应的防治进展

放射性口腔黏膜反应是头颈部肿瘤患者放射治疗中常见的并发症，常在放疗开始2～3周出现。近年来，国内外专家学者在预防和治疗口腔黏膜放射反应方面探索了许多方法，取得满意效果。现做综述如下。[第一段]     

金因肽对放射性口腔黏膜炎作用的护理研究

放射治疗是头颈部肿瘤治疗的主要方法之一．急性放射性口腔黏膜反应是最常见的放疗不良反应。也是主要的剂量限制性毒性。口腔黏膜损伤影响患者的吞咽、咀嚼能力及对治疗的耐受心．对此月前尚无公认的治疗和护理方法、金因肽为重组人表皮生长因子（rhEGF）可促进上皮细胞的生长增殖、创面的愈合。本研究于2006年2-12月探讨急性放射性门腔黏膜炎的临床表现、发生率、严重程度及金因肽在口腔黏膜炎护理中的作用，现报道如下。     

金因肽治疗急性放射性口腔黏膜炎的疗效观察

[目的]观察金因肽（重组人表皮生长因子,rhEGF）治疗鼻咽癌放疗引起的急性放射性黏膜炎的临床疗效。[方法]将60例鼻咽癌放疗后出现放射性口腔黏膜炎的病人随机分为治疗组与对照组各30例,治疗组在常规口腔护理后,将金因肽喷于口腔创面,对照组仅进行常规口腔护理。观察两组放射性口腔黏膜炎治疗有效率。[结果]金因肽治疗组有效率为73.3%,对照组治疗有效率为33.3%,治疗组明显优于对照组（P〈0.05）。[结论]金因肽配合口腔护理可以有效治疗鼻咽癌放疗引起的放射性口腔黏膜炎。     

金因肽治疗急性放射性口腔黏膜炎的疗效观察

[目的]观察金因肽(重组人表皮生长因子,rhEGF)治疗鼻咽癌放疗引起的急性放射性黏膜炎的临床疗效。[方法]将60例鼻咽癌放疗后出现放射性口腔黏膜炎的病人随机分为治疗组与对照组各30例,治疗组在常规口腔护理后,将金因肽喷于口腔创面,对照组仅进行常规口腔护理。观察两组放射性口腔黏膜炎治疗有效率。[结果]金因肽治疗组有效率为73.3%,对照组治疗有效率为33.3%,治疗组明显优于对照组(P<0.05)。[结论]金因肽配合口腔护理可以有效治疗鼻咽癌放疗引起的放射性口腔黏膜炎。     

放射性口腔黏膜反应的防护进展

头颈部肿瘤由于其特定的解剖位置和对放射线的敏感性，通常使用放射治疗。由于头颈部肿瘤本身可使唾液的一些成份发生改变；放疗又直接破坏唾液腺使唾液分泌减少，从而改变口腔细菌构成及口腔微生态环境；据Llory和Dammron等报道放疗后产酸菌较正常人和放疗前明显增多，唾液缓冲能力下降。因此，口腔黏膜反应难以避免。放射性口腔黏膜反应多在照射剂量达到10～30Gy时出现，约在放疗开始后2～3周时最为严重。主要表现为患者口咽干痛、下咽痛，随着放疗剂量的逐渐增加，疼痛逐渐加重，检查可见口咽黏膜尤其是软颚、颚弓、咽后壁一带充血，糜烂出血，白膜形成,有些患者可自行缓解，严重的则因疼痛滴水难进，有的甚至因症状严重，被迫暂时中断放疗，以致延长治疗时间，最终导致疗效下降。近几年国内外学者对放射性口腔黏膜反应的预防、治疗及护理做了大量的研究，探索了许多方法并取得一定的疗效，现综述如下。     

低温联合洁悠神防治鼻咽癌放射性口腔黏膜反应的效果观察

目的:探讨低温联合洁悠神在放射性口腔黏膜损伤中的防治效果。方法:将132例鼻咽癌患者随机分为实验组和对照组各66例,均采用双侧面颈联合野加颈切线照射。两组均按常规护理,实验组整个放疗期间均于放疗前将冰袋置于照射野皮肤30 m in,然后立即放疗。口腔一旦出现黏膜溃疡,清洁创面后用洁悠神喷洒创面,以减轻疼痛,促进愈合。结果:放疗后第3、6周末实验组口腔黏膜反应程度明显低于对照组(P<0.01),放疗结束后1周口腔黏膜反应程度也低于对照组(P<0.05)。结论:低温联合洁悠神可有效防治放射性口腔黏膜反应。     

早期全程雾化吸入预防异基因造血干细胞移植患者口腔黏膜炎的疗效研究

目的 探究早期全程雾化吸入对异基因造血干细胞移植(allo-HSCT)患者口腔黏膜炎的预防疗效。方法 纳入2018年1月至2019年12月于我院接受allo-HSCT的64例患者根据入院顺序先后分为实验组和对照组。32例实验组患者予常规护理联合早期全程雾化吸入,32例对照组患者予常规护理,比较两组患者口腔黏膜炎的发生时间、溃疡分级程度及疼痛情况。结果 实验组与对照组口腔黏膜炎发生率分别为71.8%,100%(P=0.002)。实验组发生口腔黏膜炎时间较对照组延迟(P=0.001),且溃疡分级程度较对照组降低(P=0.001),疼痛程度较对照组减轻(P=0.000)。结论 早期全程雾化吸入可以显著降低 allo-HSCT患者口腔黏膜炎的发生率,减轻口腔黏膜炎的分级程度及疼痛程度,是一种较好的口腔黏膜炎的预防方法,值得在临床中推广使用。     

辛夷花漱口液预防口腔黏膜炎的临床观察

目的探讨用辛夷花漱口液行口腔护理减少口腔黏膜炎和口臭的可行性。方法采用随机抽样法将80例不能进食患者分成两组,每组40例。观察组用辛夷花漱口液进行口腔护理;对照组用0.9%的盐水进行常规口腔护理。观察两组口腔黏膜炎、口臭的发生情况。结果观察组患者口腔黏膜炎、口臭的发生率明显低于对照组(P<0.05)。结论辛夷花漱口液行口腔护理可以有效地减少口腔黏膜炎及口臭的发生。     

Growth factors and cytokines in the prevention and treatment of oral and gastrointestinal mucositis

Goals of work Growth factors and cytokines may be useful in preventing chemotherapy (CT)- and radiotherapy (RT)-induced oral and gastrointestinal mucositis. Two systematic reviews of the medical literature on growth factors and cytokines for the amelioration of CT- and RT-induced mucositis throughout the alimentary tract were performed by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology. The aim of these evidence-based scientific reviews was to critically evaluate the literature and create evidence-based guidelines for the use of growth factors and cytokines in the prevention or treatment of CT- and RT-induced mucositis.Method The two reviews covered articles on clinical trials from January 1966 through May 2002 and preclinical studies from June 2002 through May 2005, respectively. The systematic review process was based on a well-established method for evaluating scientific literature.Main results The number of articles in the first review was 29. In the second review, 23 articles were evaluated, 14 preclinical and 9 clinical studies. It was concluded from the first review that there was no sufficient evidence to provide any recommendations for clinical practice guidelines regarding growth factors and cytokines. From the second review, a guideline could be presented recommending the use of recombinant human keratinocyte growth factor-1 (palifermin) to prevent oral mucositis in patients receiving high-dose CT and total body irradiation followed by stem cell transplantation for haematological malignancies. A guideline could also be provided suggesting that granulocyte macrophage colony-stimulating factor mouthwash not be used for the prevention of oral mucositis in the transplant setting with high-dose CT and autologous or allogeneic stem cell transplantation.Conclusions These systematic reviews have provided clarity and shown exciting new results. Further studies will provide new options for this debilitating side-effect of cancer therapy.     

Clinical consequences of oral mucositis

OBJECTIVE: To identify the clinical manifestations, risk factors, secondary complications, and assessment and management of oral mucositis. DATA SOURCES: Professional journals, websites, and books. CONCLUSION: Secondary consequences of oral mucositis include infection, xerostomia, hemorrhage, and nutritional deficits. IMPLICATIONS FOR NURSING PRACTICE: Nurses should have an extensive knowledge base about the appropriate interventions that can be used to alleviate or lessen the consequences often associated with oral mucositis.     

NASA light-emitting diodes for the prevention of oral mucositis in pediatric bone marrow transplant patients

OBJECTIVE: The purpose of this study was to determine the effects of prophylactic near-infrared light therapy from light-emitting diodes (LEDs) in pediatric bone marrow transplant (BMT) recipients. BACKGROUND DATA: Oral mucositis (OM) is a frequent side effect of chemotherapy that leads to increased morbidity. Near-infrared light has been shown to produce biostimulatory effects in tissues, and previous results using near-infrared lasers have shown improvement in OM indices. However, LEDs may hold greater potential for clinical applications. MATERIALS AND METHODS: We recruited 32 consecutive pediatric patients undergoing myeloablative therapy in preparation for BMT. Patients were examined by two of three pediatric dentists trained in assessing the Schubert oral mucositis index (OMI) for left and right buccal and lateral tongue mucosal surfaces, while the patients were asked to rate their current left and right mouth pain, left and right xerostomia, and throat pain. LED therapy consisted of daily treatment at a fluence of 4 J/cm(2) using a 670-nm LED array held to the left extraoral epithelium starting on the day of transplant, with a concurrent sham treatment on the right. Patients were assessed before BMT and every 2-3 days through posttransplant day 14. Outcomes included the percentage of patients with ulcerative oral mucositis (UOM) compared to historical epidemiological controls, the comparison of left and right buccal pain to throat pain, and the comparison between sides of the buccal and lateral tongue OMI and buccal pain. RESULTS: The incidence of UOM was 53%, compared to an expected rate of 70-90%. There was also a 48% and 39% reduction of treated left and right buccal pain, respectively, compared to untreated throat pain at about posttransplant day 7 (p < 0.05). There were no significant differences between sides in OMI or pain. CONCLUSION: Although more studies are needed, LED therapy appears useful in the prevention of OM in pediatric BMT patients.     

Current trends in managing oral mucositis

Oral mucositis is an inflammatory and ulcerative process of the oral cavity that results from an assault on the epithelial mucous membrane tissue and most commonly is associated with the administration of radiotherapy and chemotherapy. The incidence of oral mucositis ranges from 15%-40% in patients receiving stomatotoxic chemotherapy or radiotherapy and 70%-90% in bone marrow recipients. Knowledge regarding the pathophysiology of oral mucositis has evolved and now guides practice. Assessment tools to measure the level of mucositis provide valuable data concerning the status of the oral cavity. No single oral assessment tool has been found to be appropriate in all clinical settings. Mucositis has a significant impact on patients' quality of life and treatment plan. Management of oral mucositis is aimed at minimizing this side effect and its subsequent sequelae. The strategies of care are geared toward early intervention and supportive care for patients at risk for developing mucositis and include specific targeted therapies for the management of debilitating side effects. This article provides an overview of the risk factors, pathophysiology, incidence, impact, clinical presentation, oral assessment tools, management strategies, and nursing implications related to oral mucositis.