嚼槟榔与口腔黏膜下纤维化癌变之间的关系  

The relationship between betel nut chewing and oral submucosal fibrosis and canceration

作　　者：赵明宇 陶子荣[2] 陈秀文 曾健[3] 蒲菁华[3] 常和平 ZHAO Mingyu;TAO Zirong;CHEN Xiuwen;ZENG Jian;PU Jinghua;CHANG Heping(The Second Xiangya Hospital Central South University,Changsha 410011,China;Teaching and Research Section of Clinical Nursing,Xiangya Hospital of Central South University,Changsha 410008,China;Xiangya Hospital Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅二医院,长沙410011 [2]中南大学湘雅医院临床护理学教研室,长沙410008 [3]中南大学湘雅医院,长沙410008

出　　处：《当代护士（上旬刊）》2021年第8期4-7,共4页Modern Nurse

基　　金：湖南省科技厅普惠性政策与创新环境建设计划-科普专题(2020ZK4012)。

摘　　要：目的观察嚼槟榔与口腔黏膜下纤维化癌变之间的关系。方法选取2019年1月—12月于本院就诊且行手术治疗的160例口腔黏膜下纤维化(oral submucous fibrosis,OSF)癌变患者作为病例组,选取本院同期门诊就诊的OSF但无口腔鳞状细胞癌的患者160例作为对照组,采用调查问卷形式展开,调查内容主要包括:①OSF相关信息:患者何时开始使用槟榔、咀嚼槟榔持续时间(年)、每天咀嚼槟榔量(颗/d);②OSF专科检查:病理诊断分期;③口腔癌相关信息:发病时间、手术后病理分级。采用单因素分析、Mantel-Haenszel分层分析,多因素分析采用非条件logistic回归分析咀嚼槟榔及其与口腔癌间的关系。结果研究结果显示,咀嚼槟榔时间与OSF癌变呈现明显的正相关关系(P<0.001),每日咀嚼槟榔量与OSF癌变呈现明显的正相关关系(P<0.001),Mantel-Haenszel分层分析结果显示不同年龄的每日嚼槟榔量对口腔黏膜下癌变差异无统计学意义;每日咀嚼槟榔量ORMH值明显>未调整时ORC,提示年龄对每日咀嚼槟榔量具有缩小作用。非条件logistic回归分析结果显示年龄(OR 95%CI:1.087~4.498)、咀嚼槟榔时间(OR 95%CI:1.267~4.212)和日咀嚼槟榔颗数(OR 95%CI:1.526~3.202)为OSF癌变的独立危险因素。结论年龄越大、咀嚼槟榔时间越长、每日咀嚼槟榔数量越多是OSF癌变的独立危险因素,且咀嚼槟榔的时间和量与OSF癌变呈明显的正相关关系。Objective To observe the relationship between betel nut chewing and oral submucosal fibrosis and canceration.Methods 160 OSF cancer patients from January to December in 2019 were selected as the case group,and 160 OSF patients without oral squamous cell carcinoma treated were selected during the same period as the control group.This research was conducted with questionnaire.The contents of the survey mainly include:①OSF related information:when patients start chewing betel nut,the duration of betel nut consumption(years),the daily consumption of betel nut(grains/day);②OSF specialist examination:pathological diagnosis stage;③Information related to oral cancer:pathological grade after operation.Univariate and Mantel-Haenszel stratified analysis and unconditional logistic regression analysis were used to analyze the relationship between betel nut and oral cancer.Results The research shows that the chewing time of areca was significantly positively correlated with the cancer of OSF(P<0.001),and the daily chewing amount of areca was significantly positively correlated with the cancer of OSF(P<0.001).Mantel-Haenszel stratified analysis results showed that there was no statistical difference between the daily chewing amount of areca at different ages on the submucosal cancer of the mouth.When the ORMH value of daily areca chewing was obviously,ORC value was not adjusted,suggesting that age has a reducing effect on daily areca chewing.The results of non-conditional logistic regression analysis showed that age(OR 95%CI:1.087-4.498),chewing time(OR 95%CI:1.267-4.212)and daily chewing betel nut number(OR 95%CI:1.526-3.202)were independent risk factors for OSF canceration.Conclusion The older you are,the longer you chew betel nut,and the more you chew betel nut every day are independent risk factors for OSF canceration,and the time and amount of betel nut consumption are positively correlated with OSF canceration.

关 键 词：槟榔 口腔黏膜下纤维化 口腔癌 关系 

分 类 号：R78[医药卫生—口腔医学]