鼻咽癌患者放疗期间放射性口腔黏膜炎的影响因素研究  

Influence factors of radiation-induced oral mucositis during radiotherapy in patients with nasopharyngeal carcinoma

作　　者：叶彩仙[1] 吴怡[1] 贾燕[1] 谢淑萍[1] 应丽[1] YE Caixian;WU Yi;JIA Yan;XIE Shuping;YING Li(Department of Head and Neck Radiotherapy,Zhejiang Cancer Hospital,Hangzhou 310022,Zhejiang,China)

机构地区：[1]浙江省肿瘤医院头颈放疗科,浙江杭州310022

出　　处：《中国现代医生》2023年第10期1-5,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019ZD002)。

摘　　要：目的 探讨鼻咽癌患者放疗期间发生放射性口腔黏膜炎(radiation-induced oral mucositis,RIOM)的影响因素。方法 选取2019年1月至2020年8月于浙江省肿瘤医院行放射治疗的465例鼻咽癌患者,采用美国肿瘤放射治疗协作组口腔黏膜炎分级标准评估患者放疗期间的RIOM严重程度,将0~Ⅰ级者纳入对照组,Ⅱ~Ⅳ级者纳入试验组。采用单因素分析探讨影响鼻咽癌患者放疗期间发生RIOM的影响因素。结果 鼻咽癌患者放疗期间RIOM的发生率随放射剂量增加而升高,至放疗结束时RIOM发生率100%,其中轻度47.5%,重度52.5%。RIOM的影响因素在不同放疗时期略有差异,放疗10次时,年龄≥60岁、无口服营养支持及患者参与的主观全面评定评分为重度的患者重度RIOM发生率较高;放疗20次及放疗结束时,对RIOM严重程度的影响因素相似,年龄≥60岁、TNM分期3~4期、有吸烟史、诱导化疗的患者重度RIOM发生率较高,使用白细胞介素-11、抗生素治疗及给予口服营养支持的患者重度RIOM发生率较低。结论 鼻咽癌患者RIOM发生率随放射剂量增加而升高,放疗期间的影响因素略有差异,临床护理人员应根据不同时期的影响因素特点采取针对性措施及预见性干预。Objective To investigate the influence factors of radiation-induced oral mucositis(RIOM) in patients with nasopharyngeal carcinoma during radiotherapy.Methods A total of 465 patients with nasopharyngeal carcinoma who received radiotherapy in Zhejiang Cancer Hospital from January 2019 to August 2020 were selected to evaluate the severity of RIOM during radiotherapy using the oral mucositis grading standard of Radiation Therapy Oncology Group.Grades 0 to Ⅰ were included in control group,and grades Ⅱ to Ⅳ were included in experimental group.Univariate analysis was used to investigate the factors affecting the occurrence of RIOM in patients with nasopharyngeal carcinoma during radiotherapy.Results The incidence of RIOM in nasopharyngeal carcinoma patients increased with the increase of radiation dose during radiotherapy,and the incidence of RIOM was 100% at the end of radiotherapy,including 47.5% for mild and 52.5% for severe.The influencing factors of RIOM vary slightly in different radiotherapy periods.At 10 times of radiotherapy,the incidence of severe RIOM was higher in patients aged ≥60 years,without oral nutritional support and with the scores of patient-generated subjective global assessment.The influencing factors the severity of RIOM were similar after 20 radiotherapy sessions and at the end of radiotherapy.The incidence of severe RIOM was higher in patients ≥60 years,TNM stage 3 to 4,a history of smoking,and induction chemotherapy,and was lower in patients who used interleukin-11,antibiotics,and oral nutritional support.Conclusion The incidence of RIOM in nasopharyngeal carcinoma patients increased with the increase of radiotherapy dose,and the influencing factors were slightly different during radiotherapy.Clinical nurses should take targeted measures and predictive intervention according to the characteristics of influencing factors at different periods.

关 键 词：鼻咽癌 放射治疗 放射性口腔黏膜炎 影响因素 

分 类 号：R473[医药卫生—护理学]