【word】 放化疗所致口腔黏膜炎危险因素分析和护理干预.docVIP

放化疗所致口腔黏膜炎危险因素分析和护理干预 沈阳医学院JournalofShenyangMedicalCollege第13卷第1期2011年3月?39? 放化疗所致口腔黏膜炎危险因素分析和护理干预 冯华栋 (沈阳医学院护理学院基础护理教研室,辽宁沈阳110034) [摘要]目的:探讨放化疗所致口腔黏膜炎的危险因素,为预防和降低口腔黏膜炎的发生提供科学依据.方法:对99例 放化疗患者口腔状态进行横断面调查分析,以其中34例口腔黏膜炎患者为研究组,65例非口腔黏膜炎患者为对照组,比 较两组患者在年龄,肿瘤部位,化疗方案,口腔评估得分等l2个方面的差异,首先对这两组资料进行单因素x检验,然 后选择差异有统计学意义的影响因素进行Logistic多因素回归分析.结果:放化疗所致口腔黏膜炎的发生率为34.3%.发 生部位的构成比中,颊部为27.4%,牙龈为16.1%,硬腭为3.2%.口腔黏膜炎发生分度构成比中I度口腔黏膜炎为 47.1%,度为8.8%.多因素分析最终进入回归方程的影响因素有:恶心呕吐,住院天数,含5一氟尿嘧啶化疗,肿瘤部 位,白细胞下降程度和口腔评估得分.结论:放化疗所致口腔黏膜炎的发生率为34.4%,多发于颊,牙龈等非角化上皮组 织,以I度口腔黏膜炎的发病率最高.与口腔黏膜炎发生有关的危险因素是:恶心呕吐,住院天数长,化疗方案中含5-氟 尿嘧啶,头颈部位肿瘤,白细胞下降严重及口腔评估得分高.为了减少口腔黏膜炎的发生,除了做好常规基础护理外,还 要加强对护理人员的教育,重视口腔评估,并根据引起口腔黏膜炎的各种危险因素,采取针对性的护理干预. [关键词]口腔黏膜炎;放疗;化疗;危险因素;护理 [中图分类号]R473.73[文献标识码]A[文章编号]1008—2344(2011)0l一0039—04 RiskFactorsandNursingInterventioninRadiotherapyandChemotherapy-inducedOralMucositis FENGHua—dong (DepartmentofBasicNursing,NursingSchoolAffiliatedtoShengangMedicalCollege,Shengyang110034,China) [Abstract]Objective:Tofindoutwhattherisk~ctorsareinradiotherapyandchemotherapyinducedoralmucositis,thenscien- tificevidencescanbeprovidetopreventandreducetheincidenceoforalmucositis.Methods:Across-sectionssurveywasdone among99caseswhowereacceptingchemotherapyandradiotherapy,allthemedicalreCO~Softheresearchwerereviewed.34cases withoralmucositiswereputinthestudygroup,65caseswithnon—oralmucositiswereputincontrolgroup.Thedifferencesofage, tumorlocation,oralassessmentscore,andothernineriskfactorsbetweenthetwogroupswerecompared.Thedatawereanalyzed withsinglefactorxtestandLogisticregressionanalysis.Results:Theincidenceoforalmucositiswas34.3%.Therespectivelyin— cidencesofcheekandguminjurywere27.4%and16.1%.Buttheincidenceofhardpalatewas3.2%.Therespectivelyincidences ofIand1Vdegreeoralmucositiswere47.7%and8.8%.Aftermultivariateanalysis,nauseaandvomiting,hospitalizationdays,5- fluorouracilchemotherapy,tumorlocation,decreaseextentofwhitecellandoralassessmentscoreseventuallyenteredtheregressione- quation.Conclusion:Theincidenceofchemotherap