口腔照护计划在防治血液肿瘤患者化疗相关口腔炎中的效果评价  被引量:6

Evaluation of an oral care protocol on prevention and treatment of chemotherapy-induced oral mucositis in patients with hematological neoplasms

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作  者:徐艳华 沈南平[3] 孙舒君[1] 汪靖 Xu Yanhua;Shen Nanping;Sun Shujun;Wang Jing(Department of Nursing,Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区:[1]上海交通大学医学院附属瑞金医院血液中心,200025 [2]上海交通大学医学院附属瑞金医院骨髓移植,200025 [3]上海交通大学医学院附属上海儿童医学中心护理部,200127

出  处:《中国实用护理杂志》2018年第23期1801-1806,共6页Chinese Journal of Practical Nursing

摘  要:目的探讨口腔照护计划防治血液肿瘤患者化疗相关口腔黏膜炎的效果。方法选择2017年3-10月在上海某三级综合医院血液肿瘤科接受治疗的106例血液肿瘤患者,以2017年3-6月接受治疗的患者为对照组,以7-10月接受治疗的患者为干预组。对照组按护理常规进行护理,干预组患者实施口腔照护计划,持续21d,比较2组患者的口腔健康状况。结果化疗7、14、21d时,干预组患者发生Ⅰ、Ⅱ、Ⅲ、Ⅳ级口腔黏膜炎的例数分别为11、13、17、1例,28、16、0、0例,9、3、0、0例,均低于对照组的24、18、10、2例,2l、13、12、0例,13、9、8、0例,2组比较差异均有统计学意义(Z=-2.177、-2.504、-2.113,均P〈0.05);化疗3、7、14、21d时,干预组患者口腔疼痛评分的中位数(四分位数间距)分别为2.00(2.50)、3.00(2.75)、2.50(2.00)、0.00(1.oo)分,均低于对照组的3.00(4.00)、5.00(3.25)、5.50(4.00)、2.00(3.25)分,2组比较差异均有统计学意义(z=-4.925-2.587,均P〈0.05);干预组患者咽拭子微生物学检验结果阳性率为14.6%(7/48),低于对照组的36.2%(21/58),2组比较差异有统计学意义(r=6.318,P〈0.05)。结论基于循证实践方案和最佳推荐证据的血液肿瘤口腔照护计划能有效减少化疗相关口腔炎的发生,缓解口腔疼痛程度,减少口腔感染。Objective To determine the effectiveness of an oral care protocol on prevention and treatment of chemotherapy-induced oral mucositis in patients with hematological neoplasms. Methods Totally 106 patients with hematological neoplasms undergoing therapies from March to October 2017 were enrolled. Patients who were included from March to June 2017 constituted the control group, others from July to October constituted the intervention group. Patients in control group received the regular care, while patients in intervention group received a 3-week period oral care protocol. The oral health status of the patients was recorded and compared between the two groups. Results On the 7th,14th, 21th day after chemotherapy, the oral mucositis level of Ⅰ degree, Ⅱ degree, Ⅲ degree and Ⅳ degree of the intervention group were 11, 13, 17, 1 cases, 28, 16, 0, 0 cases, 9, 3, 0, 0 cases, which were lower than the control group whose degrees were 24, 18, 10, 2 cases, 21, 13, 12, 0 cases, 13, 9, 8, 0 cases, respectively. The difference between the two groups was statistically significant (Z=-2.177, -2.504,-2.113, P 〈0.05). On the 3th, 7th, 14th and 21th day after chemotherapy, the oral pain scores reported by patients in the intervention group were 2.00(2.50), 3.00(2.75), 2.50(2.00), 0.00 (1.00), which were lower than the control group whose scores, in contrast, were 5.00(4.00), 5.00(5.25), 5.50 (4.00), 2.00(3.25). The difference between the two groups was statistically significant (Z=-2.587,- 3.326, - 4.925,- 3.217, P 〈0.05). The positive rate of microbial examination in the intervention group was 14.6% (7/48), which was lower than 36.2% (21/58) in the control group. The difference between the two groups was statistically significant(X^2=6.318, P〈0.05). Conclusions The oral care protocol established and implemented based on evidence could effectively decrease the incidence of chemotherapy-induced oral mucositis, ease oral pain and reduce inflammation for patients with h

关 键 词:血液肿瘤 口腔黏膜炎 口腔照护计划 

分 类 号:R473.73[医药卫生—护理学]

 

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