放射性口腔黏膜炎照护方案的循证实践效果

Evidence-based practice effect of care scheme for radiation-induced oral mucositis

目的:制订头颈部肿瘤放疗患者口腔健康照护规范,并评价其效果。方法:运用循证医学方法获得最佳证据,并结合临床实际情况形成头颈部肿瘤患者口腔健康行为护理建议,制定放射性口腔黏膜炎口腔健康行为照护方案、流程、宣教手册及视频等。采用便利抽样法,选取2015年7—12月在复旦大学附属肿瘤医院进行头颈部放疗的237例头颈部肿瘤患者作为研究对象,2015年7—8月入院的104例患者为对照组,2015年9—12月入院的133例患者为干预组。干预组运用放射性口腔黏膜炎照护方案实施照护,对照组给予常规的治疗和护理,比较两组患者口腔黏膜炎发生情况及严重程度。结果:护理干预后,两组放射性口腔黏膜炎第2、3周发生情况,第1~3周口腔黏膜炎分级比较,差异均有统计学意义(P<0.05)。结论:基于循证医学证据的口腔健康行为护理方案可降低放射性口腔黏膜炎发生率,减轻放疗反应,提高临床护理质量。

Objective To formulate oral health care standards for patients with head and neck cancer radiotherapy and evaluate their effects.Methods The best evidence was obtained by using evidence-based medicine,and nursing suggestions on oral health behavior for patients with head and neck cancer were formed based on the actual clinical situation.According to it,oral health behavior care scheme,procedures,education manuals and videos for radiation-induced oral mucositis were formulated.Using the convenient sampling method,a total of 237 patients with head and neck cancer who received head and neck radiotherapy in Fudan University Shanghai Cancer Hospital from July 2015 to December 2015 were selected as the research objects.A total of 104 patients who were admitted from July 2015 to August 2015 were set as the control group,while 133 patients who were admitted from September 2015 to December 2015 were set as the intervention group.The intervention group used care scheme for radiation-induced oral mucositis to implement care,while the control group was given routine treatment and care.The occurrence and severity of oral mucositis between the two groups were compared.Results After the intervention,the incidence of radiation-induced oral mucositis in the second and third weeks,and the grades of oral mucositis in the first to third weeks between the two groups were statistically significant(P<0.05).Conclusions Oral health behavior nursing scheme based on evidence-based medical evidence can reduce the incidence of radiation-induced oral mucositis,reduce radiotherapy response and improve the quality of clinical care.