重组人白细胞介素11在白血病患者化学治疗后口腔溃疡的疗效观察

目的针对白血病患者化学治疗(化疗)后口腔溃疡及疼痛问题,探讨其治疗及护理措施。方法 2010年10月-2012年2月,将98例白血病化疗后发生口腔溃疡患者分为观察组、对照组各49例,观察组使用重组人白细胞介素11(rhIL-11)配置为漱口液治疗,对照组使用重组人粒细胞刺激因子注射液(GM-CSF)配置为漱口液治疗。结果治疗3 d后,观察组患者口腔黏膜反应分度情况明显好于对照组,观察组患者口腔溃疡愈合时间较对照组好。结论使用rhIL-11可有效治疗白血病患者化疗后口腔溃疡的发展与愈合,有利于化疗计划的顺利完成。     

自制冰镇含漱液治疗化疗所致口腔溃疡的效果观察

目的探讨自制冰镇含漱液治疗化疗所致口腔溃疡患者的治疗效果。方法对100例化疗期间出现口腔溃疡的患者随机分成对照组和实验组,对照组选用传统的含漱液,实验组选用自制的冰镇含漱液进行漱口治疗,观察两组口腔溃疡的愈合的程度与所需时间。结果实验组患者口腔溃疡的愈合明显快于对照组。结论冰镇含漱液科学、安全、有效,可有效的控制口腔黏膜反应的发展,加速口腔溃疡由重度向轻度转化。     

重组人粒细胞集落刺激因子治疗化疗患者口腔黏膜溃疡的效果评价

目的 探讨重组人粒细胞集落刺激因子治疗化疗患者口腔黏膜溃疡的临床效果及应用价值.方法 回顾性分析40例经化疗后出现口腔黏膜溃疡患者的一般资料,按照随机、对照的原则分为观察组和对照组各20例.对照组患者采用普通常规的口腔护理,观察组采用重组人粒细胞集落刺激因子进行护理治疗.观察和比较2组患者的护理治疗效果及口腔黏膜炎愈合的平均时间.结果 观察组临床总有效率为100.0％,对照组临床总有效率为60.0％,2组比较,观察组治疗效果明显优于对照组；观察组患者口腔黏膜溃疡愈合的平均时间为(2.4±1.5)d,对照组患者口腔黏膜溃疡愈合的平均时间为(4.3±1.9)d,2组比较,观察组患者溃疡愈合的平均时间明显短于对照组.结论 临床采用重组人粒细胞集落刺激因子对化疗后出现口腔黏膜溃疡的患者护理治疗效果较好,能够加速患者口腔黏膜炎的愈合,改善患者的病情及预后,提高患者的生存质量,值得临床进一步大胆推广应用.     

GM-CSF漱口液对白血病病儿口腔溃疡的影响

目的探讨粒-巨噬细胞集落刺激因子（GM-CSF）漱口液漱口对白血病病儿化疗后口腔溃疡的影响。方法将90例白血病病儿随机分为两组,应用甲氨喋呤＋三联鞘内注射预防中枢神经系统白血病,剂量为3 g/m2。对照组（50例）应用14 g/L碳酸氢钠＋甲硝唑液漱口;实验组（40例）应用14 g/L碳酸氢钠＋甲硝唑＋GM-CSF液漱口,观察并比较两组病儿口腔溃疡的发生率、程度及愈合时间。结果实验组病儿口腔溃疡的发生率为27.5%,对照组为36.0%,两组比较差异有显著性（2χ=14.58,P〈0.05）。实验组口腔溃疡的愈合时间短于对照组,差异有显著性（t=5.786,P〈0.05）。对照组溃疡严重程度明显高于实验组,差异有显著性（Z=2.848,P〈0.05）。结论 GM-CSF漱口液漱口防治白血病病儿化疗后口腔黏膜溃疡效果优于常规漱口液。     

三种不同漱口液在急性白血病粒缺口腔溃疡的观察与效果评价上海交通大学医学院附属瑞金医院 200025

【】 目的：探讨使用三种漱口水用于急性白血病患者口腔溃疡的观察与效果评价。方法：将确诊为急性白血病实施化疗后的粒细胞缺乏(白细胞≤2×10₉)的住院患者90例随机双盲分为治疗组1、治疗组2和对照组,每组各30例。第1组：重组人粒细胞巨噬细胞刺激因子(GM-CSF)漱口,第2组：甲硝唑漱口液漱口,第3组：甲硝唑+重组人粒细胞巨噬细胞刺激因子漱口。明确哪种漱口液对急性白血病患者化疗后粒缺患者口腔溃疡愈合的效果。结果：观察组患者治愈率明显高于治疗组1及2组,口腔溃疡愈合时间和出现时间显著缩短,差异有统计学意义(P＜0.05)。结论：选择合适的漱口液,在预防及控制口腔病原菌生长的同时,还能促进口腔黏膜     

金因肽配合口腔护理治疗化疗引起口腔溃疡的疗效观察

目的评价金因肽（重组人表皮生长因子，rhEGF）配合口腔护理治疗化疗引起的口腔溃疡的临床疗效。方法将88例化疗引起的口腔溃疡患者随机分为对照组和试验组。试验组在常规口腔护理后，使用金因肽喷于口腔溃疡区域的黏膜，对照组行常规口腔护理，分别观察两组口腔溃疡治疗有效率。结果对照组治疗有效率为72．7％，试验组治疗有效率为95．5％，两组有显著性差异。结论金因肽配合口腔护理可以有效治疗化疗引起的口腔溃疡，方法简便，值得推广。     

自制中药含漱液治疗艾滋病患者口腔念珠菌感染的效果观察

目的观察自制中药含漱液治疗艾滋病患者口腔念珠菌感染的临床效果。方法按入院时间将80例口腔念珠菌感染的艾滋病患者分为观察组、对照组各40例。观察组用中药含漱液、对照组用3%碳酸氢钠每日行口腔护理及含漱;治疗后7d、14d行咽拭子培养,治疗后14d比较两组口腔黏膜白斑、溃疡存留数。结果咽拭子培养白假丝酵母菌阳性率,治疗后7d观察组47.5%、对照组70.0%,治疗14d观察组0.08%、对照组25.0%;口腔黏膜白斑、溃疡观察组少于对照组,两组比较差异有统计学意义(P<0.05)。结论中药含漱液治疗艾滋病口腔念珠菌感染效果明显。     

中药含漱液治疗口腔黏膜病的疗效观察

目的：观察中药含漱液治疗口腔黏膜病的临床效果。方法：将176例口腔黏膜病患者随机分为两组,治疗组（n=119）采用自制中药含漱液治疗,对照组（n=57）采用金栀洁龈含漱液治疗。结果：治疗组有效率97．48％,对照组有效率73．68％,治疗组疗效与对照组相比有统计学差异（P〈0．01）。结论：中药含漱液治疗口腔黏膜病有明显疗效。     

重组人粒细胞集落刺激因子防治急性淋巴细胞白血病患儿口腔溃疡效果观察

目的探讨预防化疗所致口腔溃疡的有效方法,缩短口腔溃疡愈合时间。方法60例在诱导缓解阶段、巩固治疗阶段、大剂量MTX髓外白血病预防阶段、加强化疗阶段的急性淋巴细胞白血病患儿,按入院单日为实验组,双日为对照组分为两组各30例。对照组在化疗期单纯用常规口腔护理:2%碳酸氢钠溶液漱口,制霉菌素溶液搽口腔黏膜,3次/d,清晨、饮食前后、睡觉前后朵贝氏溶液漱口,口腔吹氧2次/d,15 min/次;实验组在常规口腔护理基础上,化疗开始时加用重组人粒细胞集落刺激因子(G-CSF)100μg 生理盐水20 ml配制的药液进行口腔护理。观察两组患儿口腔溃疡的发生率、口腔溃疡分度、溃疡愈合时间等。结果实验组患儿口腔溃疡的发生率明显降低,经2χ检验有显著性差异(P<0.005);两组患儿发生口腔溃疡的程度,经秩和检验有显著性差异(P<0.01),实验组以轻度为主,对照组以重度为主;溃疡愈合时间实验组明显缩短(P<0.001)。结论G-CSF配制溶液能预防口腔黏膜溃疡发生,减轻病情,促进口腔黏膜溃疡修复,提高患儿对化疗的耐受能力,其效果优于常规口腔护理。     

rhGM-CSF雾化吸入及漱口治疗急性白血病病人化疗所致口腔炎的疗效观察

[目的]探讨重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)雾化吸入及漱口治疗急性白血病化疗病人口腔炎的临床效果。[方法]将180例急性白血病化疗后发生口腔黏膜炎病人随机分为对照组、漱口组和雾化组各60例。对照组常规采用0.9%氯化钠注射液、利多卡因、维生素B12漱口液治疗,漱口组采用0.9%氯化钠注射液及rhGM-CSF注射液含漱,雾化组采用0.9%氯化钠注射液及rhGM-CSF注射液雾化吸入。治疗7d后进行效果评价,观察病人口腔黏膜炎治疗有效率、口腔黏膜炎愈合时间。[结果]对照组经治疗后部分病人口腔炎有所缓解,漱口组与雾化组治疗有效率明显高于对照组(P0.05),漱口组与雾化组口腔炎治疗有效率比较差异无统计学意义(P0.05)。对照组口腔炎愈合时间为(10.10±3.48)d,漱口组口腔炎愈合时间为(5.70±2.83)d,雾化组口腔炎愈合时间为(5.35±2.63)d,漱口组及雾化组愈合时间较对照组明显缩短(P0.05)。3组治疗过程中均未发现明显不良反应。[结论]应用rhGM-CSF漱口及雾化吸入均可提高急性白血病化疗所致口腔黏膜炎的治疗效果,能够加速病人口腔黏膜炎的愈合,缩短治疗时间。     

白介素-11治疗化疗所致口腔溃疡的疗效观察

目的探讨治疗化疗所致口腔溃疡的有效方法。方法自2004年4月～2005年4月对化疗后出现口腔溃疡的患者40例随机分组对照观察，治疗组给予白介素-11漱口液治疗，对照组给予1：5000呋喃西林液漱口，维生素B12口服。结果患者对漱口液耐受性良好，与对照组相比，白介素-11漱口液对口腔溃疡具有良好的治疗效果。结论白介素-11对化疗所致口腔溃疡有显著疗效，可减轻化疗所致口腔溃疡给患者带来的痛苦，提高生活质量，值得推广。     

亚叶酸钙与碳酸氢钠含漱预防大剂量甲氨蝶呤致口腔溃疡的效果研究

目的 探讨亚叶酸钙与碳酸氢钠溶液交替含漱预防大剂量甲氨蝶呤所致口腔溃疡的效果.方法 将60例大剂量甲氨蝶呤化疗的患儿随机分为实验组及对照组,每组30例.对照组给予生理盐水含漱,实验组给予0.1%亚叶酸钙与1%碳酸氢钠溶液交替漱口.观察两组患者口腔溃疡发生率及溃疡发生程度.结果 实验组口腔溃疡发生率、程度明显低于对照组,两者比较差异有显著差异(P<0.01).结论 大剂量甲氨蝶呤化疗的患儿使用0.1%亚叶酸钙与1%碳酸氢钠溶液交替漱口,可以有效预防口腔溃疡的发生.

Abstract：

Objective To explore the effectiveness of preventing oral ulcer by using high dose methotrexate with calcium folinate and sodium bicarbonate gargle alternatively.Methods Sixty patients of high dose methotrexate chemotherapy were randomly divided into experiment group and control group, with 30 patients in each group, Normal saline was given to those in the control group for gargle, and calcium folinate and sodium bicarbonate gargle alternatively for those in the experiment group, The incidence and grade of oral ulcer were observed.Results The incidence of oral ulcer and grade were markedly lower in the experiment group than that in control group. The difference between the two groups was significant(P<0.01).Conclusions Alternate gargling with calcium folinate and sodium bicarbonate is effective in the prevention of incidence of oral ulcer in patients with high dose methotrexate chemotherapy.     

粒巨细胞集落刺激因子预防化疗后口腔溃疡的研究

目的：为减轻化疗所致口腔溃疡给患带来的痛苦，探讨预防化疗所致口腔溃疡的有效方法。方法：63例患随机分成两组，从第2疗程化疗中开始，A组用3％的碳酸氢钠漱口液，B组用粒巨细胞集落刺激因子（GM－CSF）漱口液。结果：患对两组漱口液均能耐受使用，但两组相比，粒巨细胞集落刺激因子漱口液改善口爱粘膜反应程度效果优于碳酸氢钠漱口液。结论：粒巨细胞集落刺激因子对化疗所致口腔溃疡有显疗效，可减轻化疗所致口腔溃疡患的痛苦，值得推广使用。     

口腔氧气吹拂法预防骨肉瘤患者大剂量甲氨蝶呤化疗后口腔溃疡的效果

目的 观察口腔氧气吹拂法预防骨肉瘤患者大剂量甲氨蝶呤化疗后口腔溃疡的效果.方法 选取接受静脉化疗的骨肉瘤患者52例作为研究对象,按照随机数字表法将患者分为对照组和观察组,每组26例.对照组化疗时采用亚叶酸钙漱口,观察组化疗开始时即给予24 h间断口腔氧气吹拂.观察并比较2组患者化疗后7d内口腔溃疡发生率、口腔溃疡程度分...     

利多卡因联合不同浓度罗库溴铵缓解注射痛的研究

目的探讨利多卡因联合不同浓度罗库溴铵对注射痛的缓解作用。方法选择行经1：2插管全麻的择期手术患者120例（ASAI-Ⅱ级）,按随机数字表法分为A、B、C组各40例。三组患者均静脉注射利多卡因30mg10s后,静脉注射罗库溴铵10mg（A组浓度为10mg／ml,B组浓度为5mg／ml,C组浓度为1mg／m1）,10s内推注完,立即测评患者疼痛评分,记录MAP、HR、SpO：及输注并发症。结果三组患者注射痛发生率分别为35．0％,25．0％和2．5％;A、B组疼痛程度比较差异无统计学意义（P〉0．05）;C组疼痛程度与A、B组比较差异均有统计学意义（P〈0。01）;各组MAP、HR、Sp02及输注并发症比较差异无统计学意义（P〉0．05）。结论预先注射利多卡因30mg／ml,罗库溴铵稀释到1mg／ml推注能简单、有效的预防男崖淖咎辟射痛．     

Differential effects of lidocaine on nerve growth factor (NGF)‐evoked heat‐ and mechanical hyperalgesia in humans

We investigated the effects of a non‐specific sodium channel blocker (lidocaine) on heat pain thresholds and mechanical impact pain at day 7 and 21 after intradermal injection of 1 μg NGF. Measurements were performed in 12 healthy male subjects prior to and 5 min after intradermal injection of 150 μl lidocaine administered at concentrations of 0.01% (～0.4 mM) and 0.1% (～4 mM) to both NGF and control skin sites. NGF caused a maximum reduction of heat pain thresholds at day 7 (NGF 42.6 ± 0.6 vs. 49.4 ± 0.3 °C in control skin). Lidocaine sensitized normal skin for heat pain, but reduced heat hyperalgesia after NGF at day 7 (44.3 ± 0.8 °C, lidocaine 0.1%; p < 0.005). Pain upon supra‐threshold mechanical impact stimulation was increased after NGF at day 7 (VAS 29 + 5) and massively enhanced at day 21 (VAS 64 + 5, p < 0.001). Lidocaine dose‐dependently attenuated mechanically‐induced pain at both control and NGF‐treated sites. Maximum lidocaine effects on mechanical hyperalgesia were recorded at day 21 in NGF skin (pain reduction to VAS 37 ± 4, p < 0.00001). Repetitive impact stimuli caused increasingly more pain at the NGF sites at day 21 and this pain increase was efficiently suppressed by lidocaine 0.1%. Lidocaine differentially affects NGF‐induced mechanical hyperalgesia (analgesic effect) and heat sensitivity of nociceptors (sensitizing effect). These opposing responses may be attributed to block of sodium channels vs. sensitization of TRPV1. NGF‐evoked extreme mechanical impact pain indicates high action potential discharge frequencies, which might be more susceptible to lidocaine block.     

Comparison of articaine and lidocaine for infiltration anaesthesia in patients undergoing bone marrow aspiration and biopsy

Infiltration anaesthesia with articaine, a local anaesthetic able to penetrate bone, may relieve procedural pain better than lidocaine in bone marrow aspiration and biopsy. This randomised, double‐blind study comprised 150 patients with suspected or known haematologic disease. Either articaine 20 mg/ml (50 patients), articaine 40 mg/ml (49 patients) or lidocaine 20 mg/ml (51 patients), all with adrenaline 5 μg/ml, was infiltrated in volume of 6 ml (sternal manubrium), 8 ml (sternal body) or 10 ml (iliac crest) 2 min before puncture. Numeral rating scale score (median, range) at injection of local anaesthetic was 3.0 (0–10), at bone puncture 2.0 (0–8), at aspiration 3.5 (0–10) and at biopsy (48 patients) 3.0 (0–10). Pre‐procedural anxiety, rated on a verbal scale, correlated significantly with experienced pain (P < 0.01). Very anxious patients had fewer previous bone marrow examinations (P < 0.01) and they experienced more pain during aspiration (P < 0.05). In the post‐interview 42 patients reported appearance of pain (median 2.0, range 1–7) after 6.2 h, on average, and 15 patients needed oral analgesics. No parameter differed significantly between the groups. In conclusion, the quality of infiltration anaesthesia for bone marrow punctures and aspiration with articaine and lidocaine was similarly poor. Several patients experienced strong pain which correlated with the degree of anxiety.     

活性银离子抗菌液预防小儿白血病化疗后口腔溃疡的效果及其对患儿血浆细胞因子的影响

[目的]探讨活性银离子抗菌液对急性淋巴细胞白血病患儿化疗致口腔溃疡预防效果及其对患儿血浆细胞因子的影响.[方法]选择本院2015年1月至2017年2月期间收治的确诊为急性淋巴细胞白血病的患儿118例,按照随机数表法将其分为观察组和对照组各59例,所有患儿入院后完善各项检查,均采用标准方案进行化疗,化疗期间对照组患儿给予生理盐水或1%双氧水进行常规口腔护理干预,清理完毕后让患儿含漱生理盐水或1%双氧水,观察组患儿在对照组患儿的口腔清理基础上给予活性银离子抗菌液含漱,每次5~10mL,含漱5min,每日于早晚及三餐后各一次,至患儿口腔溃疡恢复.观察记录两组患儿的口腔溃疡发生率及口腔溃疡恢复时间,根据抗癌药物急性及亚急性毒性反应分度标准对患儿的口腔溃疡严重程度进行评定,同时分别在治疗前和治疗后一周,采用酶联免疫吸附测定法(ELISA)对患儿血浆中的白介素-2(IL-2)、干扰素-g(IFN-g)、肿瘤坏死因子-ɑ(TNF-ɑ)等细胞因子水平进行测定.[结果]观察组患儿的口腔溃疡发生率及口腔溃疡恢复时间均显著低于对照组患儿,差异具有统计学意义(P<0.05);观察组患儿的口腔溃疡严重程度显著轻于对照组患儿,两组患儿口腔溃疡严重程度比较差异具有统计学意义(Z=25.162,P<0.05);治疗后两组患儿的TNF-ɑ水平均显著降低,IL-2及IFN-g水平显著升高,且观察组患儿的TNF-ɑ水平明显低于对照组,IL-2及IFN-g水平明显高于对照组,差异均具有统计学意义(P<0.05).[结论]活性银离子抗菌液能够有效预防急性淋巴细胞白血病患儿化疗引起的口腔溃疡,促进口腔溃疡预后,改善患儿血浆IL-2、IFN-g、TNF-ɑ水平,增强患儿免疫功能,值得临床推广应用.     

伍用利用卡因减少异丙酚注射痛

目的：观察伍用不同剂量的利用卡因对异丙酚注射痛的影响。方法：２００例女性患者ＡＳＡⅠ～Ⅱ级,随机分为４组,每组５０例,采用双盲法分别静注１ｍｌ０．９％盐水、０．５％利多卡因（５ｍｇ）、１％利多卡因（１０ｍｇ）、２％利多卡因（２０ｍｇ）与１９ｍｌ１％异丙酚混合液,观察各组异丙酚注射痛的发生情况。结果：利多卡因明显减小了异丙酚静注即刻和麻醉苏醒后回忆的疼痛发生率及严重程度。利多卡因剂量与异丙酚静注疼痛的发生率及严重程度呈负相关（二者均Ｐ〈０．００１）。结论：伍用利多卡因２０ｍｇ明显减少异丙酚注射痛的发生率及严重程度。     

Intraocular pressure and quality of blockade in peribulbar anesthesia using ropivacaine or lidocaine with adrenaline: a double-blind randomized study

The aim of this study was to compare the effects of ropivacaine with those of lidocaine on the intraocular pressure (IOP) and the quality of the blockade in peribulbar anesthesia for cataract surgery. Fifty patients were allocated randomly into two groups and received 7-10 ml of 0.75% ropivacaine or 2% lidocaine with adrenaline, though the peribulbar two-point injection. The quality of the blockade was assessed by ocular and eyelid akinesia, pain during the peribulbar injection, and surgical satisfaction. The duration of the motor block was also evaluated after surgery. The IOP was measured using a Tonopen before the blockade (control) and at 1, 5, and 10 min after injection of the anesthetic. Lidocaine induced significantly lower akinesia scores at 6, 8, and 10 min post-injection than did ropivacaine. The mean IOP (mmHg) was significantly lower with respect to the baseline level at 10 min after blockade in the ropivacaine group compared with the lidocaine group. Ropivacaine also caused less pain on injection. There was no difference in surgical satisfaction between the groups. The duration of the motor block obtained with ropivacaine was longer than that obtained with lidocaine. Our data indicate that ropivacaine has efficacy similar to lidocaine, with slightly longer onset and duration of the motor blockade. In addition, ropivacaine (0.75%) induces lower IOP and less pain on injection than does lidocaine (2%) when used in peribulbar anesthesia for cataract surgery.