系统口咽处理防治急性放射性黏膜反应的临床观察  

Effect of systematic oropharyngeal management in prevention of acute radiation mucositis

作　　者：鞠桂芳[1] 路平华[1] 王文霞[1] 焦玉红[1] 

机构地区：[1]山东省肿瘤防治研究院放疗科,山东济南250117

出　　处：《中华肿瘤防治杂志》2009年第13期1031-1032,1035,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了观察系统口咽处理防治急性放射性黏膜反应的疗效,对60例初治头颈部肿瘤放疗患者,随机分成治疗组(30例)和对照组(30例)。治疗组常规口腔护理,同时联合用药(口泰、康复新、金因泰和利多卡因)系统口咽处理;对照组常规口腔护理,出现黏膜反应后静脉滴入维生素、激素等。观察急性口咽黏膜反应出现时间、程度及药物不良反应。结果两组间急性放射性黏膜反应的发生率比较差异无统计学意义,P>0.05;两组间黏膜反应出现的时间比较差异有统计学意义,P<0.05,治疗组以Ⅰ、Ⅱ级口咽黏膜反应为主(70.0%),对照组以Ⅲ、Ⅳ级为主(60.0%),两组间比较差异均有统计学意义,P<0.05,治疗组以轻度疼痛为主(VAS评分0～3分,63.3%),对照组以中、重度疼痛为主(VAS评分4～6分,7～10分,66.6%),两组间比较差异均有统计学意义,P<0.05;未见药物不良反应。初步研究结果提示,系统口咽处理可推迟放射性黏膜反应的发生,并降低Ⅲ、Ⅳ级黏膜反应的发生率,治疗操作简单易行,值得临床推广应用。The objective of this study was to evaluate the effect of systematic oropharyngeal management in pre vention of acute mucositis induced by radiotherapy. Sixty patients with head and neck cancer were randomized into 2 groups： a treatment group （30 cases） and control group （30 cases）. The patients in the treatment group received sys tematic oropharyngeal management and normal oral cavity nursing during the irradiation course, from beginning to the end. The other patients in the control group only received daily regular oral cavity nursing and intravenous infusion of vitamins and hormone when mucous membrane injury was found. Comparing with the rates of acute irradiation mucosi tis between the two groups, there was no significant difference （P〉0.05）. Regarding to the grade of irradiation mu cositis, the majority of patients in the treatment group were at stage Ⅰ-Ⅱ （70.0%）, while those in the control group were at stage Ⅲ-Ⅳ（60.0%）, there was a significant difference between the 2 groups （P〈0.05）. To compare with the time mucous membrane injury was found during the irradiation, there was also a significant difference between the two groups （P〈0.05） as well as pain degree （P〈0.05）. The patients in the treatment group were mostly in low-grade pain felling （VSA 0-3, 63.3 %）and others in the control group were mostly in middle and serious-grade （VSA 4-6,7-10, 66.6%）. No side effects were observed in both groups during irradiation process. In conclu sion, the systematic oropharyngeal management is able to postpone the development of radiation mucositis. This preparation is also able to lower the incidence of grade Ⅲ,Ⅳ mucositis, and it has a potential for clinical application.

关 键 词：头颈部肿瘤/放射疗法 辐射损伤 口腔黏膜/损伤 随机对照试验 治疗结果 

分 类 号：R473.73[医药卫生—护理学]