放射性口腔黏膜炎影响因素结构方程模型的建立及实证研究

EstablishmentAnd Empirical Study of Structural Equation Model of Factors Influencing Radiation Oral Mucositis

目的分析放射性口腔黏膜炎(RIOM)的危险因素,观察以RIOM结构方程模型为指导的护理服务对减少RIOM的作用。方法通过问卷调查的方式构建结构方程模型,制定新的防治方案。选取2022年8月至2023年8月在广西医科大学第一附属医院放疗科住院的头颈部肿瘤患者为研究对象,按3:1的比例分为试验组(59例)与对照组(21例)。试验组采取以RIOM结构方程模型为指导的护理服务,对照组采取常规护理。分别在两组放疗前、放疗后1个月、3个月,评估对比RIOM发生率及严重程度,验证新防治方案的有效性。结果对照组在放疗后1个月、3个月RIOM总发生率分别为71.43%、28.57%,高于同期试验组的35.59%、13.56%;对照组在放疗后1个月、3个月严重RIOM发生率分别为19.05%、9.52%,高于同期试验组的5.08%、1.69%。两组RIOM总发生率、严重RIOM发生率比较,差异均有统计学意义(P<0.05)。结论以RIOM结构方程模型为指导的护理服务对减少头颈部肿瘤放疗患者RIOM的发生、减轻RIOM严重程度均具有重要临床意义。

Objective:To analyze the risk factors of radiation-induced oral mucositis(RIOM)and observe the significance of nursing service guided by RIOM structural equation model in reducing RIOM.Methods:A structural equation model was established by questionnaire survey,and a new prevention and control scheme was formulated.From August 2022 to August 2023,patients with head and neck tumors hospitalized in the radiotherapy department of the First Affiliated Hospital of Guangxi Medical University were selected as the research objects,and were divided into experimental group(59 cases)and control group(21 cases)according to the ratio of 3:1.The experimental group took the nursing service guided by RIOM structural equation model,while the control group took the routine nursing.Before radiotherapy,1 month and 3 months after radiotherapy,the incidence and severity of RIOM were evaluated and compared to verify the effectiveness of the new prevention and treatment scheme.Results:The total incidence of RIOM in the control group was 71.43%and 28.57%one month and three months after radiotherapy,respectively,which was higher than that in the experimental group(35.59%and 13.56%).The incidence of severe RIOM in the control group was 19.05%and 9.52%one month and three months after radiotherapy,respectively,which was higher than that in the experimental group(5.08%and 1.69%).The total incidence of RIOM and the incidence of severe RIOM between the two groups were statistically significant(P<0.05).Conclusion:Nursing service guided by RIOM structural equation model has important clinical significance in reducing the occurrence and severity of RIOM in patients with head and neck tumor undergoing radiotherapy.