口腔冷疗联合大量康复新液含服在异基因造血干细胞移植并发口腔黏膜炎中的效果观察
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摘要
目的探讨口腔冷疗联合大量康复新液含服在异基因造血干细胞移植并发口腔黏膜炎患者中的应用效果。方法采用回顾性病例资料分析,选取2014年3月至2017年4月在山西医科大学第二医院血液科接受异基因造血干细胞移植的40例患者作为研究对象,分为观察组与对照组,每组20例患者。对照组患者单纯采用口腔冷疗法防治口腔黏膜炎,观察组在此基础上联合大量康复新液含服。结果①对照组与观察组患者口腔黏膜炎发生率分别为100%、90%;②对照组患者口腔黏膜炎持续时间高于观察组(16±5)d与(11+7)d,差异有统计学意义(t=3.76,P<0.05);③对照组患者发生口腔黏膜炎0级0例(0)、Ⅰ级1例(5%)、Ⅱ级5例(25%)、Ⅲ级11例(55%)、Ⅳ级3例(15%);观察组分别为0级2例(10%)、Ⅰ级0例(0)、Ⅱ级10例(50%)、Ⅲ级6例(30%)、Ⅳ级2例(10%),2组比较差异有统计学意义(χ2=7.91,P<0.05)。结论采用口腔冷疗联合大量康复新液含服能够缩短口腔黏膜炎的持续时间,降低患者口腔黏膜炎严重程度,减少口腔感染机会,减轻患者的痛苦与不适感。
Objective To investigate the efficacy of oral cold therapy combined with massive Kangfuxin mouthwash for treatment of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation. Methods This retrospective analysis of medical records included 40 recipients of allogeneic hematopoietic stem cell transplantation registered to the Department of Hematology, Second Affiliated Hospital of Shanxi Medical University from March 2014 to April 2017, who were divided into the study group and the control group(n=20 each). Subjects in the control group were given oral cold therapy alone to prevent oral mucositis, while the study group received additionally massive use of Kangfuxin mouthwash as part of combination therapy. Results ①The incidence rate of oral mucositis was 100%in the control group vs 90% in the study group, respectively. ②The oral mucositis lasted longer in the control group compared with the study group(16±5 vs 11±7)d(t=3.76, P<0.05), with significant difference. ③The oral mucositis of the study group was less severe than that in the control group. The severity of mucositis was nonecase(0) with grade0, 1(5%) with grade I, 5(25%) with grade Ⅱ, 11(55%) with grade Ⅲ and 3(15%) with grade Ⅳ in the control group, compared with 2 cases(10%) with grade 0, none(0) with grade Ⅰ, 10(50%) with grade Ⅱ, 6(30%) with grade Ⅲ, and 2(10%) with grade Ⅳ in the study group, showing significant difference between the two groups( χ2=7.91, P<0.05). Conclusion Oral cold therapy combined with massive use of Kangfuxin mouthwash may shorten the duration of oral mucositis, reduce the severity of such condition, help control the chance of oral infection, and mean-while relieve pain and discomfort.
Objective To investigate the efficacy of oral cold therapy combined with massive Kangfuxin mouthwash for treatment of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation. Methods This retrospective analysis of medical records included 40 recipients of allogeneic hematopoietic stem cell transplantation registered to the Department of Hematology, Second Affiliated Hospital of Shanxi Medical University from March 2014 to April 2017, who were divided into the study group and the control group(n=20 each). Subjects in the control group were given oral cold therapy alone to prevent oral mucositis, while the study group received additionally massive use of Kangfuxin mouthwash as part of combination therapy. Results ①The incidence rate of oral mucositis was 100%in the control group vs 90% in the study group, respectively. ②The oral mucositis lasted longer in the control group compared with the study group(16±5 vs 11±7)d(t=3.76, P<0.05), with significant difference. ③The oral mucositis of the study group was less severe than that in the control group. The severity of mucositis was nonecase(0) with grade0, 1(5%) with grade I, 5(25%) with grade Ⅱ, 11(55%) with grade Ⅲ and 3(15%) with grade Ⅳ in the control group, compared with 2 cases(10%) with grade 0, none(0) with grade Ⅰ, 10(50%) with grade Ⅱ, 6(30%) with grade Ⅲ, and 2(10%) with grade Ⅳ in the study group, showing significant difference between the two groups( χ2=7.91, P<0.05). Conclusion Oral cold therapy combined with massive use of Kangfuxin mouthwash may shorten the duration of oral mucositis, reduce the severity of such condition, help control the chance of oral infection, and mean-while relieve pain and discomfort.
引文
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[2]李冠臻,丁丽丽,李长平,等.造血干细胞移植预处理对肠屏障功能的损伤及其营养干预[J].中国临床保健杂志,2017,20(1):105-108.
[3] Cutler C,Shuli L,Haesook T,et al. Mucositis after allogeneic hematopoietis stem cell transplantation:a cohort study of methotrexate-and-non-methotrexate-containing craft-versus-host disease prophylaxis regimens[J]. Biol Blood Marrow Transplant,2005,11:383-388.
[4]顾艳荭.口腔黏膜炎每日自评问卷的汉化及信效度评价[J].中华护理杂志,2014,49(1):108-112.
[5]胡艳华,刘金玲,文月珍,等.5异基因造血干细胞移植相关性口腔黏膜炎的防治[J].现代护理,2007,13(21):1967.
[6]姜丽华.大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病口腔黏膜损害继发感染10例临床分析[J].中国小儿血液与肿瘤杂志,2009,14(3):134-136.
[7]邵琰.综合护理干预对造血干细胞移植患者口腔黏膜炎影响的研究[J].中国医学装备,2014,11(12):139-141.
[8]殷嘉.护理学基础[M].北京:人民卫生出版社,2005:274.
[9]温文姬.冰冻康复新液对造血干细胞移植后口腔黏膜炎的预防和治疗效果观察[J].吉林医学,2015,39(9):1873-1874.
[10]范美婷.局部冷疗对造血干细胞移植预处理中口腔黏膜炎愈合时间的影响[J].护理实践与研究,2013,10(10):28-29.
[11]陆茵.口腔冷疗预防放化疗所致口腔黏膜炎研究现状[J].护理研究,2011,25(10):854-855.
[12] Lilleby K,Garcia P,Gooleye T. A prospective,randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation[J]. Bone Marrow Transplant,2006,37(11):1031-1035.
[13] Gori E. Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation:a prospective randomized study of the group[J]. Bone Marrow Transplant,2007,39(6):347-352.
[2]李冠臻,丁丽丽,李长平,等.造血干细胞移植预处理对肠屏障功能的损伤及其营养干预[J].中国临床保健杂志,2017,20(1):105-108.
[3] Cutler C,Shuli L,Haesook T,et al. Mucositis after allogeneic hematopoietis stem cell transplantation:a cohort study of methotrexate-and-non-methotrexate-containing craft-versus-host disease prophylaxis regimens[J]. Biol Blood Marrow Transplant,2005,11:383-388.
[4]顾艳荭.口腔黏膜炎每日自评问卷的汉化及信效度评价[J].中华护理杂志,2014,49(1):108-112.
[5]胡艳华,刘金玲,文月珍,等.5异基因造血干细胞移植相关性口腔黏膜炎的防治[J].现代护理,2007,13(21):1967.
[6]姜丽华.大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病口腔黏膜损害继发感染10例临床分析[J].中国小儿血液与肿瘤杂志,2009,14(3):134-136.
[7]邵琰.综合护理干预对造血干细胞移植患者口腔黏膜炎影响的研究[J].中国医学装备,2014,11(12):139-141.
[8]殷嘉.护理学基础[M].北京:人民卫生出版社,2005:274.
[9]温文姬.冰冻康复新液对造血干细胞移植后口腔黏膜炎的预防和治疗效果观察[J].吉林医学,2015,39(9):1873-1874.
[10]范美婷.局部冷疗对造血干细胞移植预处理中口腔黏膜炎愈合时间的影响[J].护理实践与研究,2013,10(10):28-29.
[11]陆茵.口腔冷疗预防放化疗所致口腔黏膜炎研究现状[J].护理研究,2011,25(10):854-855.
[12] Lilleby K,Garcia P,Gooleye T. A prospective,randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation[J]. Bone Marrow Transplant,2006,37(11):1031-1035.
[13] Gori E. Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation:a prospective randomized study of the group[J]. Bone Marrow Transplant,2007,39(6):347-352.