化疗所致口腔炎的护理进展

为有效地预防和治疗肿瘤化疗后口腔炎，提高病人的生存质量，分析了血液肿瘤病人口腔炎的发病机制以及临床表现。提出疾病本身、化疗药物及治疗副反应、大剂量抗生素的使用等均可导致口腔炎的发生，并总结了多种预防和护理口腔炎的方法。     

氟尿嘧啶类药物治疗胃肠道肿瘤所致口腔炎的预防及护理

近年来,胃肠道肿瘤的发病率日益增高,在胃肠道肿瘤患者的治疗方面,新型化疗药物不断出现,但大多联合使用氟尿嘧啶(5-Fu)类药物。使用5-Fu类化疗药物的病人易并发口腔炎。有关文献报道经典的5-Fu剂量(15mg/kg·d)口腔炎的发生率为21%~63%[1]。在以往的口腔炎预防及治疗中,主要强     

头颈部肿瘤病人放疗结合氟尿嘧啶化疗致口腔炎健康教育

目的 对头颈部放疗结合氟尿嘧啶(5-FU)化疗致口腔炎肿瘤病人的健康教育进行总结,为教学和护理水平提高提供资料。方法 对70例头颈肿瘤患者,每例分别行31-35次放疗结合氟尿嘧啶(5-FU)3-4程化疗(每程3天)所致口腔炎肿瘤病人的健康教育进行回顾性研究,总结口腔炎的健康教育经验。结果 在系统健康教育下,增强了病人对口腔炎的认识,降低口腔炎发病率,减轻患者痛苦,顺利完成放化疗。结论 在系统健康教育下,加强口腔观察,及时发现症状,采取正确的防治措施,减轻患者痛苦,提高了治疗的依从性,也提高了患者生存质量。     

五银漱口液对预防血液肿瘤化疗后所致口腔炎的疗效观察

目的观察五银漱口液含漱对血液肿瘤患者化疗所致口腔炎的预防效果。方法将60例血液肿瘤化疗患者随机分为五银漱口液组30例、口泰漱口液组30例,观察两组患者口腔炎的发生率及口腔炎的构成。结果五银漱口液组的口腔炎发生率为3．3％,口泰漱口液组为26．6％,两组比较差异有统计学意义（P〈0．05）。结论五银漱口液能有效预防血液肿瘤患者化疗后所引起的口腔炎。     

生理盐水漱口预防急性白血病化疗后真菌性口腔炎的研究

[目的]探讨生理盐水漱口对急性白血病化疗后真菌性口腔炎的预防作用.[方法]将120例首诊急性白血病病人随机分成对照组和实验组,对照组采用2.5%碳酸氢钠液漱口,实验组采用生理盐水漱口,急性非淋巴细胞性白血病病人漱口从化疗第1天开始至化疗结束后21 d,急性淋巴细胞性白血病病人从化疗第1天开始,连续漱口28 d,于每天晨、晚及3餐后漱口,比较两种漱口液预防真菌性口腔炎的效果.[结果]实验组霉菌性口腔炎发生率低于对照组(P＜0.05).[结论]生理盐水漱口可预防急性白血病化疗后真菌性口腔炎.     

口炎涂剂用于化疗所致口腔溃疡的效果观察

口腔炎是肿瘤化疗中常见的并发症 ,可影响患者正常进食 ,使患者生活质量下降 ,甚至导致全身性感染而威胁生命 ,肿瘤化疗后的口腔炎发生率因肿瘤类型、化疗药品等相差很大 ,多在 2 0 %以上 ,可高达 97%。[1,2 ,4 ] 迄今为止尚无特效方法预防或护理此类口腔炎。国外曾有人报道用Ｇｍ -ＣＳＦ冲洗口腔 ,[2 ] 用含纤维蛋白溶酶、ＤＮＡ酶的冰条冷冻[1] 治疗化疗后口腔炎 ,但价格昂贵。国内多采用锡类散局部涂抹 ,甲硝唑液、洗必泰液漱口 ,也有报道用吹氧联合干扰素法等治疗口腔炎 ,但效果不够理想。我们选用一组具有抗炎、抗菌、促进粘膜上皮细…     

益口含漱液预防化疗性口腔炎的疗效观察

目的了解益口含漱液对化疗性口腔炎的预防作用.方法接受化疗的肿瘤患者151例,其中对照组74例,常规口腔护理,饭后凉开水漱口;观察组77例,早晚2次加用益口含漱液含漱.观察两组口腔炎发生情况.结果两组患者预防化疗性口腔炎有效率经统计检验,差异有统计学意义.结论益口含漱液能有效预防化疗性口腔炎的发生.     

生理盐水漱口预防急性白血病化疗后真菌性口腔炎的研究

[目的]探讨生理盐水漱口对急性白血病化疗后真菌性口腔炎的预防作用。[方法]将120例首诊急性白血病病人随机分成对照组和实验组，对照组采用2．5％碳酸氢钠液漱口，实验组采用生理盐水漱口，急性非淋巴细胞性白血病病人漱口从化疗第1天开始至化疗结束后21d，急性淋巴细胞性白血病病人从化疗第1天开始，连续漱口28d，于每天晨、晚及3餐后漱口，比较两种漱口液预防真菌性口腔炎的效果。[结果]实验组霉菌性口腔炎发生率低于对照组（P〈0．05）。[结论]生理盐水漱口可预防急性白血病化疗后真菌性口腔炎。     

西妥昔单抗联合化疗治疗结直肠癌的护理

[目的]探讨西妥昔单抗联合化疗治疗结直肠癌引起的不良反应的原因及护理对策.[方法]总结18例结直肠癌应用西妥昔单抗联合化疗的病人不良反应发生原因和护理对策.[结果]18例病人中发生皮肤反应15例,口腔炎12例,腹泻10例,恶心、呕吐12例,经过积极的预防、对症处理和护理干预,18例病人均顺利完成治疗.[结论]积极的预防、早期处理、良好的护理可预防和减少西妥昔单抗联合化疗治疗的不良反应,确保治疗顺利进行.     

低温治疗血液病病人化疗性口腔炎的效果观察

[目的]探索治疗血液病病人化疗期间口腔炎的疗效。[方法]对70例病人按住院号单双号分为实验组和对照组。实验组化疗前5min含冰,持续30min。对照组化疗前5min含2.5%碳酸氢钠稀释液,持续30min。[结果]实验组治疗化疗性口腔炎效果优于对照组。[结论]口腔低温的护理方法能减少血液病化疗性口腔炎的发生率,减轻病人的痛苦。     

化疗性口腔炎病人的护理

介绍了化疗性口腔炎相关因素评估以及吹氧、药物等治疗方法,并从增强营养、保持口腔清洁、应用黏膜保护剂等方面综述了化疗性口腔炎的护理。     

不同口腔护理时间对放射性口腔炎的影响

目的 探讨不同口腔护理时间对放射性口腔炎发生程度的影响.方法 按区组随机法将84例病人分为常规组与研究组,研究组在常规护理的基础上在放疗的第1天即进行口腔护理干预;常规组按常规方法即放疗2周后或口腔黏膜反应发生时进行口腔护理,根据肿瘤放射治疗学组(RTOG)制订的急性放射损伤分级标准评定口腔反应程度.结果 84例病人均出现不同程度的放射性口腔炎,研究组放射性口腔炎的发生程度比常规组轻(P＜0.05),统计学上检验有显著性差异.结论 放疗第1天即进行口腔护理干预,能提高病人的依从性,改善及减轻放射性口腔炎的程度,研究组疗效明显优于常规组.

Abstract：

Objective To discuss the influence of different nursing time on radioactive stomatitis. Methods The 84 patients of NPC were divided into observation group and control group randomly. The observation group received oral nursing intervention in the first day of radiation while the control group received that after 2 weeks of radiotherapy. Both group received the normal nursing process. RTOG criteria was used to evaluate the degree of the radiation stomatitis. Results The stomatitis appeared in all patients of this research, the rate and degree of radiation stomatitis was lower in observation group than that in the control group, the differences had statistically significant (P ＜0. 05) . Conclusions Nursing intervention from the lst day of radiation can increase the patients'compliance. It can improve and decrease the degree of the radiation stomatitis. The observation group has better effection than the control group.     

益口漱口液联合0．02％呋喃西林漱口液预防化疗性口腔炎临床观察

目的：研究化疗性口腔炎的有效预防方法。方法：将40例绒癌和侵蚀性葡萄胎的患者随机分为观察组和对照组,各20例,对照组给生理盐水漱口,观察组给益口漱口液联合0．02％呋喃西林漱口液交替漱口,于化疗当日起,连续14d。结果：观察组未发现重度口腔炎,口腔炎严重程度显著低于对照组（P〈0．01）。结论：益口漱口液联合0．02％呋喃西林漱口液可有效预防、减轻化疗性口腔炎,效果安全可靠。     

Effect of two oral care protocols on the incidence of stomatitis in hematology patients

Research-based oral care protocols for the control and treatment of stomatitis secondary to cytotoxic therapy are scarce in the nursing literature. The purpose of this pilot study was to determine the efficacy of two different oral care protocols in decreasing the incidence of stomatitis in patients with hematologic malignancies receiving chemotherapy and radiation therapy. It was hypothesized that patients with hematologic malignancies using oral care protocol A would have a lower incidence of treatment-induced stomatitis than patients using oral care protocol B. Eighteen subjects with hematologic malignancies treated with high doses of chemotherapy alone or in combination with radiation therapy were randomly assigned to one of two specific oral care protocols. Protocols differed in the type of lip lubricant, toothette, and mouthwash used. The Oral Assessment Guide (21) was used to assess oral status five times a week for the duration of each subject's hospitalization. A t test for independent samples was used to determine if the difference in the condition of the oral cavity was related to the different oral care treatments. A statistically significant difference was not found between the mean oral assessment scores of the two groups. A trend emerged, however, of a lower incidence of stomatitis in the subjects using the experimental oral care protocol. A serendipitous finding was that reinforcement of oral care instructions and nursing assessments of the oral cavity seemed to promote patient compliance with the oral care regime. A supplementary analysis revealed a statistically significant (r = -0.7177) negative correlation between the degree of stomatitis and the peripheral white blood cell count.     

鼻咽癌治疗后引致口腔炎的高危因素及护理对策

目的 探讨鼻咽癌患者化疗后口腔炎发生的高危因素及其护理对策。方法 对38例患者进行研究，按口腔炎发生与否分为口腔炎组16例和对照组22例，对9项临床指标行单因素、多因素Loglstic回归分析。结果 多因素Loglstic回归分析提示持续灌注、既往放疗2项指标进入多元回归方程(P=0．000)，其相对危险度分别为19．9085和8．0733。结论 持续灌注、既往放疗2项指标为口腔炎的高危因素，据此实施相应护理，可能有助于及时预防和处理口腔炎。     

中药煎剂含漱防治化疗所致口腔炎效果观察

目的：为观察中药煎剂含漱对恶性肿瘤病人化疗所致口腔炎的防治效果。方法：将肿瘤化疗病人147例随机分为实验组与对照组，实验组76例用中草药煎剂含漱，对照组71例用朵贝尔氏液含漱。结果：实验组与对照组口腔炎发生率分别为10．52％和23．94％，两组比较有统计学意义（P＜0．05）；口腔炎严重程度实验组较对照组轻（P＜0．05）；口腔溃疡愈合时间实验组较对照组明显缩短（P＜0．05）。结论：中药煎剂含漱能更有效地防治肿瘤病人化疗所致的口腔炎。     

马鞭草合剂防治放射性口腔炎的效果观察

[目的]观察马鞭草合剂对放射性口腔炎的防治效果。[方法]将120例头颈部肿瘤放射治疗病人随机分为观察组、对照1组和对照2组,每组40例。观察组遵医嘱含服马鞭草合剂;对照1组遵医嘱静脉输注左氧氟沙星注射液;对照2组遵医嘱服用甘露醇口服液。[结果]2周、8周时三组间差异无统计学意义,4周、6周时观察组与对照2组差异无统计学意义,但观察组和对照2组分别与对照1组间有显著性差异。[结论]马鞭草合剂防治放射性口腔炎经济、有效、安全。     

Management of chemotherapy-induced stomatitis

The past decade has brought about major advances in the medical management of cancer. Despite these advancements, significant toxicities often accompany the potential benefits of chemotherapy. One of the most common toxicities associated with chemotherapy administration is the development of stomatitis. Stomatitis is estimated to occur in 40% of all patients undergoing chemotherapy, and its incidence is two to three times higher in patients with hematologic malignancies and those undergoing bone marrow transplant. Many inconsistencies currently exist in strategies to prevent, assess, and treat stomatitis. Unresolved or undiagnosed stomatitis can lead to major complications such as poor treatment outcomes, increased cost of care, diminished quality of life, and, eventually, mortality. Oncology nurses share responsibility in improving patient outcomes related to stomatitis by remaining knowledgeable, using evidence-based practice, and ensuring follow-up.     

Prevention of 5-fluorouracil-related stomatitis by oral cryotherapy: a randomized controlled study.

Stomatitis is a common adverse effect of intravenously infused 5-fluorouracil (5FU). Although there are encouraging studies about the preventive role of oral cryotherapy in stomatitis induced by intravenous administration of 5FU, this simple and cost-effective method is not part of clinical practice. This prospective randomized study investigates whether oral cryotherapy alleviates 5FU-induced stomatitis. Thirty six patients, included in the cryotherapy group, were instructed to hold ice cubes in their oral cavity, shortly before, during and shortly after the infusion of 5FU. Both mean physician and patient-graded stomatitis of our cryotherapy group were compared with those of a control group (40 patients) and were found significantly reduced for all three chemotherapy cycles. The percentage of patients who were free from oral toxicity was significantly higher in the cryotherapy group in all three chemotherapy cycles, as judged both by patients and physicians. The results of this study encourage the use of cryotherapy in patients receiving 5FU in alleviating stomatitis by using a side-effect-free, easy to perform and inexpensive measure, which does not interfere with the efficacy of antineoplastic agents.