综合护理干预在预防鼻咽癌放疗患者放射性口腔黏膜炎中的应用

目的:探讨综合护理干预在预防鼻咽癌放疗患者放射性口腔黏膜炎中的临床效果。方法:将182例鼻咽癌患者随机分为干预组和对照组各91例,对照组给予常规护理,干预组在此基础上给予综合护理干预,比较两组放疗期间不同时点口腔黏膜炎发生情况及放疗第7周末口腔黏膜反应。结果:两组放疗第1,2,3,4周口腔黏膜炎发生情况及放疗第7周末口腔黏膜反应比较差异有统计学意义(P<0.05)。结论:综合护理干预能有效延缓鼻咽癌患者放射性口腔黏膜炎的出现时间,减轻炎性反应程度,值得临床推广。     

鼻咽癌患者口腔放射黏膜炎的护理

总结了放射性口腔炎的有效护理方法,为鼻咽癌放疗的顺利开展提供保证。对35例鼻咽癌患者进行综合的口腔护理、心理护理、健康教育和饮食指导等护理干预,并对护理效果进行观察。35例鼻咽癌患者均完成整个放疗过程,有13例发生I级口腔放射性黏膜炎,15例发生Ⅱ级口腔放射性黏膜炎,2例发生Ⅲ级口腔放射性黏膜炎,1例发生Ⅳ级口腔放射性黏膜炎。口脖放射性黏膜炎的发生率为88．6％（31／35）。经有效的治疗和护理,患者口腔粘膜的水肿、疼痛症状减轻或消失,溃疡范围缩小。28例患者可进食普食,3例患者溃疡面积较大,为半流质饮食。认为通过采取有效的护理方法,患者口腔黏膜炎得到了较好的控制,生存状态得到了有效的提高,保证了鼻咽癌放疗的顺利开展。     

全期前瞻匹配护理模式在鼻咽癌放疗患者口腔黏膜炎防护中的应用效果

目的：探讨全期前瞻匹配护理模式在鼻咽癌放疗患者口腔黏膜炎防护中的应用效果。方法选择2015年10~12月我院行放射治疗的鼻咽癌患者114例作为研究对象,随机分为实验组和对照组各57例。对照组接受鼻咽癌放疗常规护理,实验组在对照组基础上接受以口腔黏膜炎防护为目标的全期前瞻匹配护理干预模式,对两组患者干预后的相关指标进行比较。结果实验组鼻咽癌放疗患者干预后的口腔黏膜炎发生时间显著晚于对照组,愈合时间显著早于对照组,第3周末、7周末的口腔黏膜炎严重程度显著低于对照组,护理满意度评分显著高于对照组,差异均有统计学意义( P<0.05)。结论对鼻咽癌放疗患者实施以口腔黏膜炎防护为目标的全期前瞻匹配护理干预模式,能显著推迟该类患者口腔黏膜炎的发生时间,降低口腔黏膜炎严重程度,促进炎症愈合,提高护理满意度。     

鼻咽癌放射治疗并发口腔黏膜炎447例的原因分析及护理

总结447例鼻咽癌放射治疗并发口腔黏膜炎的原因及护理.鼻咽癌并发口腔黏膜炎与疾病因素、放射治疗、化疗、使用抗生素、口腔卫生不佳等有关.重视口腔卫生,加强营养支持,按医嘱对症治疗,做好心理护理,能促进口腔黏膜炎症状缓解及消失.     

护理干预在减轻鼻咽癌患者放疗中口腔黏膜炎的作用

放射治疗是鼻咽癌主要的治疗手段之一,放射线在杀死肿瘤细胞的同时对口腔黏膜有直接的损伤作用,表现为口腔黏膜干燥、红肿、糜烂、溃疡、坏死,患者出现疼痛、出血、吞咽及张口困难等影响进食,加之对放射治疗的紧张、恐惧,造成患者的身心痛苦,甚至中断放疗,严重影响了治疗效果和生活质量.     

敛疮解毒方中药含漱护理方案在预防放射性口腔黏膜炎中的效果研究

目的 观察敛疮解毒方中药含漱护理方案在预防放射性口腔黏膜炎中的临床应用效果。方法 选取常州市第一人民医院2020年2月至2022年2月收入院初次接受同步放化疗鼻咽癌放疗患者110例作为研究对象,将其随机分为对照组55例,观察组55例。观察组采用鼻咽癌放疗常规护理+敛疮解毒方中药含漱,对照组采用鼻咽癌放疗常规护理+2.5%碳酸氢钠含漱,观察两组患者放射性口腔黏膜炎的发生情况。结果 观察组患者初次发生Ⅰ级口腔黏膜炎的时间为(28.05±16.20)d,晚于对照组的(16.15±10.84)d(t=4.531,P<0.001);观察组患者初次发生Ⅱ级口腔黏膜炎的时间为(38.53±10.09)d,晚于对照组的(30.16±14.44)d(t=3.521,P=0.001)。在放疗第21天,观察组与对照组Ⅱ级及以上口腔黏膜炎发生率分别为9.09%vs. 27.27%(χ²=6.111,P=0.024),观察组患者口腔黏膜炎分级情况较对照组发生程度轻(Z=-2.642,P=0.011);第28天口腔黏膜炎的发生率分别为12.73%vs. 41.82%(χ²     

老年鼻咽癌患者放疗性口腔黏膜炎评估工具研究进展

口腔黏膜炎是老年鼻咽癌放疗患者最为常见的不良反应,其发生往往严重影响患者的治疗及生活质量。本文综述了国内外常用的ROM评估工具,并从评估工具的选择、评估时间、评估者培训等几个方面进行论述,以期为老年NPC患者的ROM临床护理评估和计划提供指导和借鉴。     

肠内营养支持在鼻咽癌患者放射性口腔黏膜炎中的应用进展

鼻咽癌是最常见的头颈部恶性肿瘤，其首选治疗方式为放射治疗，放射性口腔黏膜炎是鼻咽癌放疗过程中，发生率最高的并发症，导致患者进食减少，加重营养不良的程度，严重者会引起放疗定位的偏差，降低患者治疗的效果。本文将肠内营养在鼻咽癌患者放射性口腔黏膜炎中的应用进展作一综述。     

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。     

头颈部放射治疗致口腔黏膜炎病人的饮食护理

[目的]探讨临床头颈部放射治疗中采取综合饮食护理措施和方法,以减轻放射治疗致口腔黏膜反应带来的治疗障碍及病人的痛苦,提高病人的生活质量.[方法]选取鼻咽癌需头颈部放射治疗病人82例,随机分成干预组和对照组,干预组采用综合饮食护理干预,对照组则不予系统饮食干预.于放疗第2周、第4周、第7周对口腔黏膜进行评估.[结果]干预组第4周、第7周Ⅲ级、Ⅳ级口腔黏膜炎发生率明显低于对照组.[结论]综合饮食护理干预措施的实施减轻了头颈部放射治疗的毒性反应.     

三乙醇乳膏预防鼻咽癌患者放疗皮肤反应的效果

目的观察三乙醇乳膏（比亚芬）预防鼻咽癌放疗后放射性皮肤反应的效果。方法将110例采用直线加速器放疗的鼻咽癌患者随机分为治疗组（n=55）和对照组（n=55）,治疗组于第1次放疗后给予比亚芬乳膏涂抹照射野皮肤,对照组只做常规护理,不涂任何药物。观察两组在20Gy、50Gy和70Gy照射剂量时皮肤反应程度。结果治疗组与对照组在20Gy照射剂量时,皮肤反应发生率差异无统计学意义（χ^2=6．25,P〉0．05）;当放疗剂量达到50Gy时,治疗组皮肤反应以Ⅰ度为主,占67．27％,而对照组则以Ⅱ度（45．45％）,为主,另有14例出现Ⅲ度皮肤反应,两组间比较差异有统计学意义（x。=16．37,P〈0．01）;当放射剂量达到70Gy时,治疗组仍以Ⅰ,Ⅱ度为主（81．82％）,而对照组有70．91％的患者达到Ⅲ度,且有4例因出现极严重的皮肤反应而被迫中止放疗,组间差异具有统计学意义（χ^22=20．57,P〈0．01）。结论比亚芬乳膏能有效地预防鼻咽癌放疗后皮肤反应的发生,能减轻患者痛苦,使放射治疗顺利进行。     

Individualized pharmacological treatment of oral mucositis pain in patients with head and neck cancer receiving radiotherapy

Purpose  

Pain is a prominent symptom in radiotherapy-induced oral mucositis (OM). This study assesses the effect of pharmacological treatment in head and neck cancer patients with OM-induced pain and swallowing difficulties.     

鼻咽癌病人放疗后口部不适的质性研究

[目的]了解鼻咽癌放疗病人在接受放疗过程中口部不适症状及对日常生活的影响,以引导护士更好地为病人提供个性化的全身心护理。[方法]通过深入访谈收集15例个案资料,采用现象学分析法分析。[结果]鼻咽癌病人放疗期间口部不适主要包括4个主题:口干、味觉改变、口咽部疼痛、咀嚼/吞咽障碍。[结论]鼻咽癌病人放疗时口部不适主要表现为口干、味觉改变、口咽部疼痛、咀嚼/吞咽障碍,护理人员应深入了解病人口部不适的感受,满足病人身心需求,加强保护性预防措施,帮助其尽快摆脱治疗过程的痛苦,保证放疗计划顺利完成。     

Effectiveness of oxygen nebulization at preventing radiotherapy-induced mucositis in patients with nasopharyngeal cancer

PurposeTo evaluate the effectiveness of oxygen nebulization at preventing radiotherapy-induced mucositis in patients with nasopharyngeal cancer.MethodsSixty patients with nasopharyngeal cancer treated with simultaneous integrated boost intensity-modulated radiotherapy were randomly assigned to oxygen nebulization or ultrasonic nebulization groups; treatment was once daily for 20 minutes. All patients received routine oral care. We compared saliva pH and volume, food intake, and change in oral mucosa during radiotherapy, and dry mouth and sore throat after radiotherapy between the two groups.ResultsThere were significant differences in the incidence of grade III or IV mucositis, saliva volume and pH, and dry mouth and sore throat between the two groups when the total dose was 33 Gy (p < 0.05 or p < 0.01).ConclusionOxygen nebulization reduces radiotherapy-induced mucositis and relieves symptoms such as dry mouth and sore throat in patients with nasopharyngeal cancer.     

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.     

Reduction of oral mucositis by filgrastim (r-metHuG-CSF) in patients receiving chemotherapy

Mucositis, the inflammation and necrosis of mucosal membranes, is a serious and debilitating consequence of many cancer therapies. We were interested in the potential role of filgrastim (recombinant methionyl human granulocyte colony-stimulating factor, r-metHuG-CSF) in the reduction of mucositis. Patients with newly diagnosed small-cell lung cancer (SCLC) were treated with CAE chemotherapy (cyclophosphamide, doxorubicin, and etoposide) and placebo or filgrastim. If patients had an episode of febrile neutropenia, they received unblinded filgrastim in subsequent CAE cycles. Oral mucositis was considered to have occurred if a patient reported any clinical sign or symptom of oral mucositis with or without oral candidiasis. Oral mucositis was analyzed using the unadjusted chi-square test, and time to first episode of mucositis was analyzed using the stratified log-rank test as well as the Cox proportional hazards regression model. During cycle 1, placebo-treated patients had more episodes of mucositis (47%) compared with those patients randomized to filgrastim (28%). Across all cycles of treatment, 70% of placebo-treated patients experienced mucositis, compared with 53% of patients randomized to filgrastim. A significant reduction in the incidence of chemotherapy-related oral mucositis occurred across multiple cycles of treatment in patients treated with filgrastim.     

Apoptotic and inflammation markers in oral mucositis in head and neck cancer patients receiving radiotherapy: preliminary report

GOAL OF WORK: The aim of this study was to investigate the expression of pro-apoptotic protein p53 and anti-apoptotic proteins BCl-2 and MCl-1, as well as the expression of pro-inflammatory cytokines tumor necrosis factor (TNF) and interleukin-1beta (IL-1beta) in patients developing mucositis during radiotherapy for head and neck cancer. MATERIALS AND METHODS: Thirty-five patients receiving radiotherapy for head/neck cancer were included in this study. Patients were examined before radiotherapy. Oral mucositis was recorded weekly during radiotherapy. Cytologic smears from the oral cavity were taken with a brush. Immunocytochemical staining was performed by the use of p53, BCl-2, MCl-1 TNF and IL-1beta monoclonal antibodies. MAIN RESULTS: P53 was expressed in 1 of 15 smears before the initiation of radiotherapy (6.5%) compared to 3 of 7 smears from patients with grade III mucositis (43%) during radiotherapy. BCl-2 was expressed in 15 of 15 smears before radiotherapy (100%) and in three of seven patients with grade III mucositis (43%) during radiotherapy. MCl-1 was expressed in 10 of 14 samples before radiotherapy (71.5%) and in two of seven patients with grade III (28.5%) mucositis during radiotherapy. TNF was expressed in 9 of 14 patients before radiotherapy (64%) and in six of seven patients with grade III mucositis during radiotherapy (86%). IL-1beta was detected in 7 of 14 patients before radiotherapy (50%) compared to 6 of 7 patients with grade III mucositis during radiotherapy (86%). CONCLUSION: Our preliminary results indicate an induction of apoptosis and inflammation in the oral mucosa in patients developing mucositis during radiotherapy for head/neck cancer.