头颈部肿瘤患者放疗期间口腔健康行为的纵向调查

Oral health behaviors in head and neck cancer patients undergoing radiotherapy:a longitudinal study

目的了解头颈部肿瘤患者放疗期间的口腔健康行为,为改进临床实践提供依据。方法使用自制的口腔健康行为问卷,对104例头颈部肿瘤患者在放疗第1周(入院时)、第2周、第4周、出院时进行调查;并每周检测患者是否发生口腔黏膜炎。结果至放疗第5周,所有患者均发生口腔黏膜炎;患者口腔健康行为除"使用牙线"不同时间点比较差异无统计学意义(P>0.05)外,其余6项口腔健康行为放疗期间均有所改善(P<0.05,P<0.01);年龄对治疗期间口腔健康行为有影响(P<0.05),性别及学历对入院时的口腔健康行为影响有统计学意义(均P<0.05),之后影响无统计学意义(均P>0.05)。结论头颈部肿瘤患者放疗期间口腔黏膜炎发生率高;口腔健康行为(除使用牙线外)在入院后有所改善。医护人员需关注头颈部肿瘤放疗患者的口腔健康行为,尤其是对年长者;制定基于循证证据的口腔照护策略,以改善患者的口腔健康行为。

Objective To determine the prevalence of oral health behaviors among patients with head and neck cancer undergoing ra- diotherapy, and to provide reference for improving clinical practice. Methods One hundred and four patients were recruited and asked to complete a self-designed oral health behavior questionnaire at admission, in the second and fourth week of radiation therapy, and before discharge. Oral mucositis was measured weekly according to the Common Toxicity Criteria, version3.0. Results All patients developed oral mucositis in the first 4 weeks of radiation therapy. Six oral health behaviors, except flossing, were significantly improved during radiotherapy （P〈0.05,P〈0.01）. Age influenced oral health behaviors during the treatment （P〈0.05）; gender and education level affected oral health behaviors at admission （P〈0.05 for both）. Conclusion The prevalence of oral mueositis is high in head and neck cancer patients who undergo radiation therapy, and their oral health behaviors （except flossing） are improved during the treatment. Medical personnel should pay attention to oral health behaviors of head and neck cancer patients treated with radiotherapy, especially for the elderly. Evidence-based oral care protocol should be developed to improve oral health behaviors of patients.