集束化护理干预在乳腺癌化疗相关性口腔黏膜炎中的应用

Application of bundle care intervention on breast cancer chemotherapy related oral mucositis

目的:探讨集束化护理干预对乳腺癌化疗相关性口腔黏膜炎的改善效果。方法:选择在延安市人民医院肿瘤血液科化疗且发生化疗相关性口腔黏膜炎的乳腺癌患者作为研究对象,采用随机数字表法分为观察组和对照组,对照组采用常规的口腔护理干预措施,观察组实施集束化护理干预措施,比较两组患者干预前(D0)及干预3(D3)、5(D5)、7(D7)d后的口腔黏膜损伤程度评分、口腔疼痛评分、7 d恢复效果及总愈合时间。结果:两组在D3~7的口腔疼痛程度评分和口腔黏膜损伤程度评分均明显低于D0,且观察组的评分明显低于对照组,差异具有统计学意义(P<0.05);在干预7 d后,观察组痊愈24例、显效17例、有效10例、无效2例,对照组痊愈11例、显效14例、有效17例、无效9例,差异具有统计学意义(P<0.05);观察组的口腔黏膜炎愈合时间为(6.63±1.82)d,明显少于对照组的(11.35±2.36)d,差异具有统计学意义(P<0.05)。结论:集束化护理干预能有效促进乳腺癌化疗相关性口腔黏膜炎的创面愈合,减少口腔疼痛症状,促进疾病康复。

Objective： To discuss and analyze the effect of bundle care nursing measure on alleviating breast cancer chemotherapy related oral mucositis. Methods： Breast cancer patients who accepted chemotherapy and had chemotherapy related oral mucositis in Department of Tumor and Hematology of Yan＇an People＇s Hospital were selected as the research objects and were divided into an observation group and a control group randomly with the method of random number table. The control group adopted routine oral nursing intervention measures, while the observation group adopted bundle care intervention measures. Scores of oral mucous membrane injury degree, scores of pain in oral caviar, 7-day recovery effect and total healing time of the two groups before intervention （DO） and on the 3rd day （D3）, 5th day （D5） and 7th day （D7） after intervention were compared. Results： Scores of pain in oralcavity and scores of oral mucous membrane injury degree of the two groups from D3 to D7 were evidently lower than those on DO, and such scores of the observation group were evidently lower than those of the control group, and the differences were of statistical significance （P〈0.05）. On the 7th day after intervention, there were 24 recovery cases, 17 effect-showing cases, 10 effective cases and 2 ineffective cases in the observation group; in contrast, there were 11 recovery cases, 14 effect-showing cases, 19 effective cases and 9 ineffective cases in the control group, and the differences were of statistical significance （P〈0.05）. The oral rnucositis healing time of the observation group was （6.63±1.82） days, which was shorter than that of the control group （11.35±2.36） days, and the differences were of statistical significance （P〈0.05）. Conclusion： Clinical bundle care intervention can effectively accelerate the wound healing of breast cancer chemotherapy related oral mucositis, alleviate pain in oral cavity, and promote rehabilitation.