头颈部恶性肿瘤患儿放化疗所致口腔黏膜炎的护理策略  

Nursing strategy of oral mucositis caused by chemoradiotherapy in children with head and neck malignancies

作　　者：郭秋菊[1] 陈小萌[1] 张安琪 张谊[1] 黄东生[1] GUO Qiuju;CHEN Xiaomeng;ZHANG Anqi;ZHANG Yi;HUANG Dongsheng(Department of Pediatrics,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院儿科,北京100176

出　　处：《中国小儿血液与肿瘤杂志》2024年第1期41-43,49,共4页Journal of China Pediatric Blood and Cancer

摘　　要：目的通过有效的护理对策降低头颈部肿瘤患儿放化疗所致口腔黏膜炎(OM)的严重程度。方法选取2020年1月—2022年12月北京同仁医院儿科收治头颈部恶性肿瘤放化疗OM患儿,儿童口腔评估指南量表评分为9-16分的中度OM患儿100例,随机分为对照组和干预组,每组各50例,对照组根据医嘱用药,干预组在医嘱用药基础上加用(0-4)℃的0.9%生理盐水指导患儿在进食后、睡前、呕吐后、口腔黏膜炎用药前10分钟,利用双侧颊部运动形成水压涡流含漱,每次含漱口液10-15 mL,漱口≥30 s。干预3天后应用儿童口腔评估指南量表进行比较两组患儿口腔黏膜的严重程度及愈合时间、痛苦程度对比。结果干预组较对照组OM的严重程度明显减轻(χ^(2)=12.398,P=0.00);OM导致的痛苦程度干预组较对照组明显减轻(χ^(2)=5.263,P=0.02);OM愈合时间干预组较对照组明显短(χ^(2)=8.752,P=0.01)。结论儿童头颈部恶性肿瘤放化疗后口腔炎用生理盐水清洁口腔能明显降低OM的严重程度;减轻OM导致的痛苦;提高药物的治疗效果缩短OM的病程,具有临床推广价值。Objective To reduce the severity of oral mucositis caused by radiotherapy in children with head and neck tumors through effective nursing countermeasures.Methods From January 2020 to December 2022,100 patients with moderate oral mucositis with a score of 9-16 were randomly divided into a control group and an intervention group.In the control group,medication was administered according to medical prescription,and in the intervention group,0.9%saline(0-4℃)plus medical prescription was administered.Results Compared with two group,the severity of oral mucositis was statistically significant(χ^(2)=12.398,P=0.00),and the severity of oral mucositis was reduced in the intervention group;the degree of pain caused by oral mucositis was statistically significant(χ^(2)=5.263,P=0.02),and the degree of pain was reduced in the intervention group.The difference in healing time was statistically significant(χ^(2)=8.752,P=0.01),and the healing time in the intervention group was significantly shorter than that in the control group.Conclusions With saline cleaning after radiotherapy of head and neck malignancies in children can significantly reduce the severity and pain caused by oral mucositis;improve the therapeutic effect of drugs to shorten the course of oral mucositis,and promote clinical effect.

关 键 词：儿童 头颈部肿瘤 放化疗 口腔黏膜炎 护理策略 

分 类 号：R473.73[医药卫生—护理学]