"四步体位含漱法"对预防血液肿瘤患者联合化疗后口腔黏膜炎的效果探讨  

The effect of"four-step posture gargle"on preventing oral mucositis after combined chemotherapy in patients with blood tumor

作　　者：梅卓君 张洁 周晓丽 Mei Zhuojun;Zhang Jie;Zhou Xiaoli(Department of Hematology and Oncology,Zhabei Central Hospital,Jing'an District,Shanghai 200070,China;Department of Nursing,Zhabei Central Hospital,Jing'an District,Shanghai 200070,China)

机构地区：[1]上海市静安区闸北中心医院血液肿瘤科,200070 [2]上海市静安区闸北中心医院护理部,200070

出　　处：《中国实用护理杂志》2020年第28期2170-2174,共5页Chinese Journal of Practical Nursing

摘　　要：目的探讨"4步体位含漱法"对预防血液肿瘤患者联合化疗后口腔黏膜炎(OM)发生的效果。方法采用方便抽样方法选择2018年1月至2019年6月在上海市静安区闸北中心医院血液肿瘤科接受联合化疗的恶性血液病患者90例,根据入院患者住院号末位单、双数分为对照组和试验组,各45例。对照组采用"鼓漱含漱法",试验组采用"4步体位含漱法"。医护人员自化疗当日、3 d、7 d、14 d、21 d进行口腔评估,比较2组患者OM出现天数、OM分级、OM愈合时间、口腔pH值及化疗延迟天数的差异性。结果2组患者在出现OM天数及化疗延迟人数上差异无统计学意义(P>0.05)。试验组患者化疗后口腔pH值为6.53±0.64,高于对照组的6.01±0.57,试验组OM愈合时间为(6.76±1.82)d,较对照组的(8.87±3.06)d缩短,差异均有统计学意义(t值为4.047和3.978,P<0.05)。试验组发生0级、Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级OM例数分别为6、8、8、17、6例,均低于对照组的10、11、12、10、2例,差异均有统计学意义(χ2值为8.000~27.000,P<0.05)。结论"4步体位含漱法"为联合化疗的血液肿瘤患者提供一种全新的局部口腔护理方法,有效降低口腔黏膜炎的发生,降低疾病相关并发症,提高治疗延续性,为OM临床防治提供新策略。Objective To explore the effect of the method"four-step posture gargle"on the prevention of oral mucositis(OM)in patients with blood tumor after chemotherapy.Methods A total of 90 cases with malignant hematological diseases who were treated with chemotherapy in the department of hematologic oncology from January 2018 to June 2019 were selected by convenient sampling method.The control group used"drum gargle",and the test group used"four-step posture gargle".Oral evaluation was conducted on the days of using chemotherapy day,3d,7d,14d and 21d after chemotherapy.The differences of OM occurrence days,OM grading,OM healing time,oral pH value and chemotherapy delay days were compared between the two groups.Results No significant difference was found between the two groups in OM days and the number of patients with delayed chemotherapy(P>0.05).After chemotherapy,the oral pH value of the test group was 6.53±0.64,higher than that of the control group(6.01±0.57).The healing time of OM in the test group was(6.76±1.82)d,shorter than that of the control group(8.87±3.06)d,which were with statistically differences(t value was 4.047 and 3.978,P<0.05).Group level 0,Ⅰ,Ⅱ,Ⅲ,ⅣOM cases respectively,6,8,8,17,6 cases were lower than the control group of 10,11,12,10,2 cases,with statistically significant differences(χ2 value was 8.000-27.000,P<0.05).Conclusions"Four-step body position gargle method"provides a new method of oral care for patients with hematological tumor.The method can effectively reduce the occurrence of oral mucositis,reducing disease-related complications,improving treatment continuity.

关 键 词：血液肿瘤 化疗 口腔黏膜炎 含漱法 体位 

分 类 号：R473.73[医药卫生—护理学]