配制漱口液对肝脏恶性肿瘤患者靶向治疗引起的口腔黏膜炎的疗效分析

Analysis of the effect of mouthwash prepared with mannitol on tyrosine kinase receptor inhibitor oral mucosal adverse reactions in patients with liver cancer

目的:探讨甘露醇、利多卡因、地塞米松配制漱口液对肝脏恶性肿瘤患者靶向治疗中引起的口腔黏膜炎的疗效。方法:选择2019年8月至2021年3月中国医学科学院北京协和医学院肿瘤医院深圳医院收治的因肝脏恶性肿瘤且接受索拉非尼、仑伐替尼等分子靶向药治疗出现口腔黏膜炎的46例患者,按照随机数字表法分为研究组和对照组各23例。研究组患者应用甘露醇、利多卡因、地塞米松配制漱口液进行干预,对照组患者应用口腔黏膜炎常规护理干预。记录并比较两组患者应用配制漱口液3d和7d的数字分级评分法(numerical rating scale,NRS)评分,以及两组患者恢复普通饮食的时间。结果:应用配制漱口水当日、3d两组患者NRS评分差异均无统计学意义[(3.13±0.69)分比(3.61±0.33)分,t=-1.133,P=0.108;(1.35±0.71)分比(1.61±1.03)分,t=-0.996,P=0.074];应用配制漱口水7d研究组患者NRS评分低于对照组患者[0(0,0.50)分比(0.70±0.63)分],且差异有统计学意义(z=-2.584,P<0.015)。应用配制漱口水后,研究组患者恢复普通饮食的时间为(1.65±1.11)d,短于对照组患者恢复普通饮食的时间(3.00±0.52)d,且差异有统计学意义(t=5.26,P=0.001)。结论:甘露醇、利多卡因、地塞米松配制漱口液应用于分子靶向药引起的口腔黏膜炎效果良好。

Objective:Tyrosine kinase transmembrane receptor inhibitors are widely used in the clinical treatment of liver cancer,and oral mucosal adverse reactions may occur.This study is to explore the effect of mannitol,lidocaine,dexamethasone and mouthwash in such patients. Method: In this paper, 46 patients with liver cancer who were treated with sorafenib, lenvatinib, regorafenib or cetuximab were selected as the research objects (all oral mask reactions were grade 2-3). They were randomly divided into 23 cases in the observation group and 23 cases in the control group. The control group used mannitol, lidocaine and dexamethasone to rinse the mouth when adverse reactions to the oral mask occurred, and the observation group was. Result: The effect of oral mucosal adverse reactions in the observation group was later than that in the control group and the symptoms were milder. The difference between the two groups was significant (P<0.05). Conclusion: The mannitol, lidocaine and dexamethasone preparation has a good effect on the oral mucosal side effects of the tyrosine kinase transmembrane receptor inhibitor, and it is worthy of clinical application. This article provides references for oncology nursing workers to deal with related adverse reactions.