60例鼻咽癌长期生存者放射性龋齿现状及其影响因素分析  

Analysis of status quo of radioactive dental caries in 60 long-term survivors of nasopharyngeal carcinoma and its impacting factors

作　　者：吕文龙[1] 黄诗琪 黎珊[1] 张明炜 苏丽[1] LYU Wenlong;HUANG Shiqi;LI Shan;ZHANG Mingwei;SU Li(Department of Radiotherapy,Cancer Treatment Center,the First Affiliated Hospital of Fujian Medical University,Fujian,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院肿瘤中心放疗科,福建福州350005

出　　处：《中国医药科学》2024年第10期153-157,共5页China Medicine And Pharmacy

基　　金：福建省教育厅中青年教师教育科研项目(JAT-190202);福建医科大学启航基金项目(2021QH1087)。

摘　　要：目的 调查鼻咽癌长期生存者放射性龋齿的现状,分析其发生、发展的影响因素。方法 收集2012年1月至2017年12月在福建医科大学附属第一医院接受根治性放疗且生存期>5年的鼻咽癌患者60例,采用龋齿、缺牙和补牙指数(DMFS160)和中文版的口腔健康影响概况5(OHIP5)评估患者的放射性龋齿程度及口腔相关并发症、口腔相关生活质量。分析放射性龋齿对口腔相关生活质量的影响,探讨其发生、发展的影响因素。结果 60例患者中,出现放射性龋齿38例(63.3%)。口腔相关并发症评估中,放射性龋齿和口干的严重程度较高,二级以上放射性龋齿和口干的发生率分别达到51.7%和48.4%。OHIP5总分平均为[5.5(3,7)]分,OHIP2和OHIP3得分最高,分别为[1.5(1,2)]分。将患者分为发生和未发生龋齿组,龋齿组的口腔相关生活质量明显下降。多因素分析结果显示,年龄(β=0.200,P=0.026)、有无龋齿(β=0.266,P=0.002)、吞咽困难(β=0.660,P<0.001)对口腔相关生活质量的影响,差异有统计学意义(P <0.05);放疗后刷牙次数(β=-2.166,P=0.022)和每次刷牙时长(β=-1.844,P=0.039)是放射性龋齿发生的保护性因素。结论 鼻咽癌长期生存者放射性龋齿的发生率较高,对口腔相关生活质量产生负面影响。放疗后刷牙的频率和每次刷牙的时长是放射性龋齿发生的临床保护性因素。Objective To investigate the status quo of radioactive dental caries in long-term survivors of nasopharyngeal carcinoma,so as to analyze the impacting factors of its occurrence and development.Methods A total of 60 patients with nasopharyngeal carcinoma who received radical radiotherapy in the First Affiliated Hospital of Fujian Medical University from January 2012 to December 2017 and whose survival time were more than 5 years were collected.The degree of radioactive dental caries,oral-related complications and oral-related quality of life(QoL)were evaluated by DMFS160 and OHIP5.The impact of radioactive dental caries on oral related QoL was analyzed,and the impacting factors of its occurrence and development were investigated.Results In 60 patients,38 cases(accounting for 63.3%)developed radioactive dental caries.In the evaluation of oral related complications,the severity of radioactive dental caries and dry mouth was relatively high,and the incidences of radioactive dental caries and dry mouth above the second grade were 51.7%and 48.4%respectively.The average total score of OHIP5 was(5.5[3,7]),while OHIP2 and OHIP3 had the highest scores,which were(1.5[1,2]).The patients were divided into the dental caries group and the non dental caries group,and the oral related QoL in the dental caries group decreased significantly.Multivariate analysis showed that age(β=0.200,P=0.026),with or without dental caries(β=0.266,P=0.002)and dysphagia(β=0.660,P<0.001)had statistically significant effects on oral related QoL(P<0.05).The frequency of brushing teeth after radiotherapy(β=-2.166,P=0.022)and the duration of brushing teeth each time(β=-1.844,P=0.039)were the protective factors of radioactive dental caries.Conclusion The incidence of radioactive dental caries in long-term survivors of nasopharyngeal carcinoma is relatively high,which has a negative impact on oral related QoL.The frequency of brushing teeth after radiotherapy and the duration of brushing teeth each time are the clinical protective factors of radioact

关 键 词：鼻咽癌 龋齿 生活质量 并发症 

分 类 号：R739.63[医药卫生—肿瘤]