内服外用联合防治儿童白血病化疗性口腔溃疡的临床研究  

Clinical observation on prevention and treatment of chemotherapy induced aphthous stomatitis in childhood leukemia

作　　者：谢忠丽 王华彬[1] 胡孙河 XIE Zhongli;WANG Huabin;HU Sunhe(Gannan Medical College First Affiliated Hospital,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000

出　　处：《临床医药实践》2024年第6期419-422,共4页Proceeding of Clinical Medicine

基　　金：江西省卫生健康委员会科技计划项目(项目编号:202130647)。

摘　　要：目的:观察内服外用联合应用防治儿童白血病化疗性口腔溃疡的临床疗效。方法:选取2020年9月—2022年12月收治的白血病患儿80例,随机分为观察组和对照组,每组40例。两组均采用标准化疗方案化疗(方案参照王卫平主编《儿科学》第九版、儿童急性髓细胞白血病诊疗建议、CCCG-ALL2015方案)。对照组患儿出现口腔溃疡后用康复新液或亚叶酸钙稀释液漱口,观察组每疗程化疗期间均口服叶酸片,出现口腔溃疡后给予制霉菌素片磨粉加生理盐水稀释后漱口+巨和粒加生理盐水稀释后漱口。两组均连续治疗5 d。观察两组患儿化疗性口腔溃疡发生率、严重程度、疼痛程度、临床疗效、患儿依从性及不良反应情况。结果:观察组化疗性口腔溃疡发生率低于对照组,严重程度轻于对照组,差异有统计学意义(P<0.05);观察组患儿依从性高于对照组,差异有统计学意义(P<0.05);两组患儿疼痛程度、临床治疗总有效率比较,差异无统计学意义(P>0.05);两组患儿治疗期间均未发生与化疗性口腔溃疡药物治疗相关的不良反应。结论:内服外用联合应用可预防儿童白血病化疗性口腔溃疡的发生,降低严重程度,且对化疗性口腔溃疡具有良好效果,利于缓解患儿疼痛感及溃疡面愈合,提高患儿化疗依从性,且安全性较高。Objective:To observe the clinical efficacy of combined oral and external use in the prevention and treatment of chemotherapeutic aphthous stomatitis in childhood leukemia.Methods:All 80 leukemia children admitted to hospitals from September 2020 to December 2022 were selected as the observation subjects and randomly divided into observation group and control group,with 40 cases in each group.All cases were treated with standard chemotherapy regimens(according to the 9th edition of pediatrics edited by Wang Weiping,the diagnosis and treatment recommendations for acute myeloid leukemia in children,and the CCCG-ALL2015 protocol).After the control group developed ulcers,the children were rinsed with kangfuxin solution or calcium folinate diluent.During each course of chemotherapy,the observation group took folic acid tablets orally.After ulcers appeared,the children were rinsed with nystatin tablet grinding powder mixed with physiological saline,and rinsed with juhe granules diluted with physiological saline.Both groups were treated continuously for 5 days.The incidence,severity,pain level,clinical efficacy,compliance,and adverse reactions of chemotherapy induced oral ulcers in two groups of children was observated.Results:The incidence of chemotherapeutic aphthous stomatitis in the observation group was lower than that in the control group,and the severity was milder than that in the control group,with a statistically significant difference(P<0.05).The compliance rate in the observation group was higher than that in the control group(P<0.05).There was no significant difference in pain degree and total effective rate between the two groups(P>0.05),and there was no adverse reaction related to chemotherapy-induced oral ulcer.Conclusion:The combination of oral and external use can prevent the occurrence of chemotherapy-induced aphthous stomatitis in childhood leukemia,reduce the severity,and has good effects on the treatment of chemotherapy-induced aphthous stomatitis,which is conducive to alleviating the pain of childr

关 键 词：儿童白血病 化疗性口腔溃疡 叶酸 制霉菌素 巨和粒 防治 

分 类 号：R725[医药卫生—儿科]