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。     

零度冰水冷疗对外周血干细胞移植患者口腔黏膜炎的预防效果

目的 探讨零度冰水冷疗在预防外周血干细胞移植患者口腔黏膜炎中的效果。方法 选取2020年12月-2021年8月在浙江大学医学院附属第一医院接受外周血干细胞移植的77例患者为研究对象,将2020年12月-2021年3月收治的39例外周血干细胞移植患者设为对照组,2021年4月-8月收治的38例外周血干细胞移植患者设为观察组。对照组给予常规口腔黏膜炎预防护理;观察组在对照组基础上实施零度冰水冷疗。比较2组口腔黏膜炎、重度口腔黏膜炎发生率及口腔疼痛程度。结果 2组口腔黏膜炎发生率及口腔疼痛评分比较,差异均无统计学意义(χ²=0.001,P=0.978;t=0.372,P=0.711),但观察组重度口腔黏膜炎的发生率低于对照组(χ²=4.988,P=0.026)。结论 零度冰水冷疗能降低外周血干细胞移植患者重度口腔黏膜炎的发生率,且操作简单易行,值得临床推广应用。     

放化疗所致放射性皮炎和口腔黏膜炎的护理

目的探讨放化疗所致放射性皮炎和口腔黏膜炎的护理要点。方法分析和总结130例鼻咽癌患者行放化疗所致放射性皮炎和口腔黏膜炎的护理方法。结果患者放射性皮炎发生程度为:Ⅰ度109例、Ⅱ度20例、Ⅲ度1例;口腔黏膜发生程度:Ⅰ度101例、Ⅱ度25例、Ⅲ度4例。结论做好放化疗期间的健康教育、皮肤及口腔黏膜的护理,并根据轻重程度采取针对性的护理方法,在一定程度上可改善放射性皮炎和口腔黏膜炎反应。     

局部冷疗对造血干细胞移植预处理中口腔黏膜炎愈合时间的影响

目的:探讨局部冷疗对造血干细胞移植预处理中口腔黏膜炎愈合时间的影响.方法:将28例以BUCY+ ATG为基本预处理方案的造血干细胞移植患者随机分为试验组和对照组各14例,对照组为常规护理组,化疗药物输注期间和进食前后使用甲硝唑漱口液常规漱口,试验组除常规护理外,化疗药物输注期间全程间断含冰(含冰时间为2h).结果:与对照组相比,试验组可以有效地缩短患者口腔黏膜炎愈合时间.结论:预处理中局部冷疗可延缓口腔黏膜炎的发生,并有效地缩短患者口腔黏膜炎愈合时间.     

4种方法预防化疗所致口腔黏膜炎效果的临床观察

目的探讨4种不同方法预防化疗所致口腔黏膜炎效果观察,选择经济、简单、有效的方法。方法将577例接受氟脲嘧啶类为主抗癌药物化学治疗的患者随机分为A、B、C、D组,A组口服别嘌呤醇片,3次/d;B组含漱0.8%别嘌呤醇溶液3次/d、20 mL/次、含漱3-5 min,含漱时间为3餐后冷开水漱口后;C组含漱口洁灵溶液,3次/d、20 mL/次、含漱3-5min,含漱时间为3餐后冷开水漱口后;D组为护理干预组,对患者进行系统健康教育。每天观察并记录发生口腔黏膜炎的病例数、程度及口腔黏膜炎持续时间。结果4组患者口腔黏膜炎的发生率、程度及发生口腔黏膜炎持续时间比较,差异无统计学意义(P<0.05)。结论通过有效的护理干预可以预防化疗所致的口腔黏膜炎,且方法经济、简单,具有一定的临床应用价值。     

重组人粒细胞巨噬细胞集落刺激因子喷雾剂对放化疗口腔黏膜炎干预作用的临床研究

目的 探讨放化疗所致口腔黏膜反应的有效防治措施.方法 将我院2010年1月～2011年7月100例头颈部恶性肿瘤放化疗患者随机分为2组,试验组采用重组人粒细胞巨噬细胞集落刺激因子( rhGM - CSF)喷雾剂治疗放化疗所致口腔黏膜炎；对照组以安慰剂对照,辅以健康教育和整体护理,观察两组药物的疗效、疼痛缓解度和安全性.结果 实验组的有效率为86％,对照组的有效率为32％,两组间差异有统计学意义(P＜0.05).试验组患者口腔疼痛缓解总有效率为76.0％,对照组为57.1％.实验组疼痛缓解显著优于对照组(P＜0.05).结论 使用( rhGM - CSF)喷雾剂能明显减轻放化疗所致口腔黏膜炎,且安全性好,使用方便.     

门诊预防和处理癌症患者放化疗后口腔黏膜炎的方法

目的 探讨门诊预防和处理癌症患者放化疗术后口腔黏膜炎的方法.方法 选择癌症患者放化疗前后自愿来门诊接受口腔检查的68例患者为观察组,同期住院接受放化疗的患者54例为对照组.观察组患者化疗术前均行口腔评估,化疗前后均给予口腔护理程序;对照组仅行化疗前后常规护理,化疗术后行口腔评估.比较两组患者口腔黏膜炎的发生比率.结果 观察组患者术后口腔黏膜炎的发生比率显著低于对照组(P＜0.05).结论 为减少口腔黏膜炎的发生,应重视口腔评估,采取针对性的护理干预.     

鼻咽癌放疗所致口腔黏膜炎的护理进展

阐述鼻咽癌放疗所致口腔黏膜炎的预防及口腔黏膜反应程度分级,从预防感染、保持口腔湿润和使用安抚剂、中医护理、含服生理盐水冰块和使用表皮生长因子等方面综述鼻咽癌放疗所致口腔黏膜炎的护理进展。     

预防造血干细胞移植患者口腔黏膜炎的不同干预方法及效果研究

目的 探讨预防造血干细胞移植患者口腔黏膜炎的不同干预方法及效果.方法 随机将35例进行以BUCY为基本预处理方案的造血干细胞移植患者分成实验组和对照组.对照组(11例)为常规护理组(即保持口腔卫生,每日于化疗药物输注期间及进食前后漱口);实验组除常规护理外,实验(1)组(12例)在化疗药物输注期全程含冰;实验组(2)组(12例)为化疗药物输注半程含冰.监测各组患者移植期间口腔黏膜、呕吐、恶心等指标.比较各组患者口腔黏膜炎评分,溃疡发生部位.结果 实验组可延缓口腔黏膜炎的发生;实验组与对照组在预防HSCT患者口腔黏膜炎发生之间差异无显著意义(x2=1.520,P=0.468＞0.05);实验(2)组与对照组在预防重度口腔黏膜炎差异有显著意义(x2 =5.423,P=0.020＜0.05).结论 实验(2)组(短程冷疗组)可用于预防HSCT患者重度口腔黏膜炎的发生.     

4种方法预防化疗所致口腔黏膜炎效果的临床观察

目的探讨4种不同方法预防化疗所致口腔黏膜炎效果观察，选择经济、简单、有效的方法。方法将577例接受氟脲嘧啶类为主抗癌药物化学治疗的患者随机分为A、B、C、19组，A组口服别嘌呤醇片，3次／d；B组含漱0．8％别嘌呤醇溶液3次／d、20mL／次、含漱3～5min，含漱时间为3餐后冷开水漱口后；C组含漱口洁灵溶液，3次／d、20mL／次、含漱3--5rain，含漱时间为3餐后冷开水漱口后；D组为护理干预组，对患者进行系统健康教育。每天观察并记录发生口腔黏膜炎的病例数、程度及121腔黏膜炎持续时间。结果4组患者口腔黏膜炎的发生率、程度及发生口腔黏膜炎持续时间比较，差异无统计学意义（P〈0．05）。结论通过有效的护理干预可以预防化疗所致的口腔黏膜炎，且方法经济、简单，具有一定的临床应用价值。     

口腔黏膜炎护理研究进展

从口腔黏膜炎的发生机制、评估量表的选用、相关危险因素及护理等方面对放疗及化疗所致口腔黏膜炎的护理研究进展进行综述。认为应依据循证医学证据,选用安全且疗效可靠的防治措施,积极处理并发症。     

肿瘤病人口腔黏膜炎的综合处理

综述了肿瘤病人口腔黏膜炎的发病机制,重点论述了血液生长素、低温保护剂以及其他措施在治疗肿瘤病人口腔黏膜炎中的应用方法。     

肿瘤病人口腔黏膜炎的综合处理

综述了肿瘤病人口腔黏膜炎的发病机制．重点论述了血液生长素、低温保护剂以及其他措施在治疗肿瘤病人口腔黏膜炎中的应用方法。     

护理干预对头颈部肿瘤放射治疗所致口腔黏膜炎的影响

目的：探讨护理干预对头颈部肿瘤放射治疗所致口腔黏膜炎的影响。方法：99例头颈部肿瘤患者随机分为两组,干预组在对照组的基础上,加强对患者的口腔卫生知识教育,实行口腔护理及物理性预防措施,合理使用抗生素。比较其与对照组之间口腔黏膜炎发生率的差异。结果：干预组口腔黏膜炎发生率66．7％,对照组发生率85．7％,两组比较差异有显著性（P〈0.05）,且干预组发生口腔黏膜炎的程度较轻,差异亦有显著性（P〈0.05）。结论：积极的护理干预可降低头颈部肿瘤放射治疗所致口腔黏膜炎的发生率。     

鼻咽癌病人口腔感染分析及干预

[目的]分析鼻咽癌病人住院期间并发口腔感染情况,探讨行之有效的干预对策。[方法]对2 0 0 2年—2 0 0 4年12 64例鼻咽癌住院病人进行口腔感染情况分析。[结果] 12 64例发生医院感染70例,感染率为5 .5 4%,其中口腔感染45例,占64 .2 9%。[结论]鼻咽癌病人并发口腔感染与肿瘤自身免疫功能低下、放化疗导致口腔黏膜损伤、机体屏障破坏、不合理应用抗生素以及周围环境等因素有关。护理人员应明确预防感染的重要性,做好消毒隔离工作,改善病房环境,合理应用抗生素。     

儿童造血干细胞移植后口腔并发症的护理

目的:探讨重型β地中海贫血患儿移植后口腔并发症的护理。方法:回顾分析2012年1月~2013年12月我科住院的154例重型β地中海贫血移植病例,采用健康宣教、心理护理、口腔溃疡分度护理相结合等综合护理,分析护理资料与口腔并发症的相关性。结果:154例患儿中有68例(44.16%)发生口腔黏膜炎,53例(34.42%)出现口腔出血。结论:进行造血干细胞移植治疗时,同时增加有效的口腔护理,能够预防并减少口腔并发症,提高疗效。     

Chemotherapy: the effect of oral cryotherapy on the development of mucositis

Aims and objective. The aim of this study is to investigate the effect of oral cryotherapy on the development of chemotherapy‐induced mucositis in patients administered combined chemotherapy. Background. Mucositis has been of interest to scientists for more than 20 years. Unfortunately, this has not resulted in the development of standard procedures for prevention and management. To cope with this side‐effect and to prevent opportunistic infections that may emerge during treatment, attempts are taken to provide preventative and comfort measures. In this context, cryotherapy (oral cooling) has become popular as a cheap and readily applicable method in preventing the developing due the rapid infusion of chemotherapy agents, or decreasing its severity. Design and method. Study involved 60 patients, 30 of whom were in the study group and 30 in the control group. Ice cubes at a size that can be moved easily in the mouth and whose corners have been smoothed in order that they will not cause irritation in the mouth has been used in oral cryotherapy in the study group. Oral chemotherapy was initiated five minutes before chemotherapy and maintained during venous infusions of etoposide (Vepesid®), platinol (Cisplatin®), mitomycin (Mitomycin‐C®) and vinblastin (Velbe®) depending on the chemotherapy course. Results. According to Patient‐Judged Mucositis Grading, the rate of mucositis is 36.7% in study group and 90.0% in control group, the difference between two groups being statistically significant (P < 0.05). According to Physician‐Judged Mucositis Grading, the rate of mucositis is 10.0% in the study group and 50.0% in the control group, the difference between two groups being statistically significant (P < 0.05). Oral pH values decreased in 90% of the subjects in study group, i.e. mucositis risk was reduced whereas oral pH values remained unchanged or decreased in 86.7% of the subjects in the control group, namely mucositis risk increased. The difference between study and control groups in terms of the change in pH values after chemotherapy was found to be statistically significant (P < 0.05). Conclusion. Our findings have demonstrated that oral cryotherapy makes an important contribution to the protection of oral health by reducing the mucositis score according to patient‐ and physician‐judged mucositis score and by increasing oral pH values. Relevance to clinical practice. Aggressive cancer therapy places patients at greater risk for oral complications and treatment‐related consequences. Unfortunately, prevention and/or treatment of such oral sequelae have often become overlooked as priorities of the treatment team. Effective approaches for the prevention or treatment of oral mucositis have not been standardized, and vary considerably among institutions. Prophylactic measures begin with an increased emphasis on improved oral status. Oral cryotherapy, the therapeutic administration of cold, is a prophylactic measure for oral inflammation. The relevance for clinical practice will be to understand the content of mucositis; comprehensive care should focus on the prevention of this complication in the clinical practice.     

Effects of professional oral health care on reducing the risk of chemotherapy-induced oral mucositis

Purpose

Recent years have seen remarkable progress in cancer therapy, although treatment-induced adverse reactions and complications are not uncommon. Approximately 40 % of patients undergoing chemotherapy for cancer experience adverse reactions in the oral cavity, with nearly half of them developing severe oral mucositis that necessitates postponing therapy and/or changing the drug dosage. The objective of this study was to assess the usefulness of prophylactic professional oral health care (POHC) for preventing mucositis in patients undergoing chemotherapy.

Methods

Twenty-six female patients scheduled for chemotherapy for breast cancer were included in this study and randomized to the self-care or POHC groups. Assessment parameters included oral cavity photographs, plaque control records, Saxon test scores, Oral Assessment Guide scores, and grading using the Common Terminology Criteria for Adverse Events. Beginning before surgery and continuing through the completion of chemotherapy, the POHC patient group received weekly professional oral health care, including scaling, professional cleaning of the tooth surfaces, brushing instructions, and nutritional and lifestyle guidance.

Results

More patients in the self-care group developed oral mucositis than in the POHC group. The Oral Assessment Guide score, which was used as an index of oral mucositis, was also significantly lower in the POHC group. Based on the Oral Assessment Guide and plaque control records, there was almost no deterioration of the oral environment in the POHC group, whereas deterioration was observed in the self-care group.

Conclusions

These findings demonstrate the efficacy of regular POHC in reducing the risk of oral mucositis in breast cancer patients undergoing chemotherapy.     

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.