异基因造血干细胞移植相关性口腔黏膜炎的防治

Prevention and treatment of oral mucositis related to allogeneic hematopoietic stem cell transplantation

目的探讨口腔黏膜炎发生原因,规律和防治对策。方法对42例移植患者的口腔黏膜加强临床观察和护理并详细记录。结果本组口腔黏膜炎发生率为83%,部位多见于舌系带及舌缘两侧、双侧颊黏膜及上腭。口腔黏膜炎的发生与粒细胞减少和细胞毒性药物对黏膜上皮细胞损伤有关,一般为10-16d愈合,与造血重建相平行。本组患者口腔黏膜炎100%愈合。结论口腔黏膜炎是造血干细胞移植患者常见而严重的并发症,加强观察和护理能降低口腔黏膜炎发生率和程度,促进愈合。

Objective To explore the pathogenesis, patterns, prevention and treatment of oral mucositis. Methods 42 patients who underwent allo-HSCT received intensive clinical observation and nursing, and the observations were recorded in details. Results In the study group, the incidence rate of oral mucositis was 83%. The oral mucositis was most commonly seen in lingual frenulum, bilateral border of tongue, bilateral buccal mucosa and palate. The pathogenesis of oral mucositis was related to the granulocytopenia and the injury of mucosa epithelium due to cytotoxic drug. The healing time was parallel with hematopoiesis reconstruction, generally ranging from 10 to 16 days. In the patients of this group, oral mucositis healed as high as 100%. Conclusions Oral mucositis is a common and serious complication of patients who underwent HSCT. Intensive clinical observation and nursing can decrease the incidence rate and lower the degree of oral mucositis, thereby helping the patients heal.