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晚期癌症患者口腔疼痛与干燥情况的调查

A survey of mouth pain and dryness in patients with advanced cancer.

作者信息

Oneschuk D, Hanson J, Bruera E

机构信息

Regional Palliative Care Program, Grey Nuns Community Health Center, Edmonton, Alberta, Canada.

出版信息

Support Care Cancer. 2000 Sep;8(5):372-6. doi: 10.1007/s005200050005.

Abstract

An 11-item face-to-face survey was conducted in 99 consecutive patients with advanced cancer to determine the prevalence, intensity, reporting and treatment, presumed cause(s), and importance of mouth pain and dryness. Sixteen of the 99 patients (16%) reported experiencing mouth pain at a mean intensity corresponding to 5.5 +/- SD 2.21 on a 0 (no pain) to 10 (worst possible pain) numerical scale, and 88 (88%) patients reported dry mouth at a mean intensity corresponding to 6.2 +/- SD 2.21. Nine (56%) of the 16 patients with mouth pain and 39 (44%) of the 88 patients with mouth dryness reported these symptoms to their attending physician(s). Sixty-nine percent (27/39) of patients who reported having a dry mouth were advised by their physician(s) to pursue one or more treatments. The most common treatments recommended (and frequencies) were drinking water/taking sips of fluid (13), gargling with bicarbonate mouthwash (4), using an artificial saliva spray (4), and using an oral fungal suspension for thrush (4). The most common findings on oral examination included: possible thrush (53 patients), upper and lower dentures (33 patients), and multiple dental restorations (23 patients). The causes most frequently assumed to be responsible were ill-fitting dentures for mouth pain, and medications and possible oral fungal infections for mouth dryness. The mean values given for the importance of the symptoms of mouth pain and dryness relative to other symptoms or problems experienced by the patients were 4.4 +/- SD 1.84 and 3.6 +/- SD 1.67, respectively, on a Likert scale ranging from 1 (not important) to 7 (great importance). Mouth dryness was more frequently reported than mouth pain. The mean rating for the intensity of mouth pain was higher than that for mouth dryness, although both were of moderate importance to patients relative to other symptoms or problems experienced at the time. Patients tended to underreport mouth pain and dryness, and physicians tended to address such complaints inadequately.

摘要

对99例晚期癌症患者进行了一项包含11个项目的面对面调查,以确定口腔疼痛和口干的患病率、强度、报告情况及治疗情况、推测病因以及重要性。99例患者中有16例(16%)报告经历过口腔疼痛,平均强度在0(无疼痛)至10(可能的最严重疼痛)的数字评分量表上为5.5±标准差2.21;88例(88%)患者报告有口干,平均强度为6.2±标准差2.21。16例口腔疼痛患者中有9例(56%)、88例口干患者中有39例(44%)向他们的主治医生报告了这些症状。报告有口干的患者中有69%(27/39)被医生建议采取一种或多种治疗措施。推荐的最常见治疗方法(及频率)为饮水/小口喝液体(13例)、用碳酸氢盐漱口水漱口(4例)、使用人工唾液喷雾(4例)以及使用口腔真菌悬液治疗鹅口疮(4例)。口腔检查中最常见的发现包括:可能患有鹅口疮(53例患者)、上下假牙(33例患者)以及多个牙齿修复体(23例患者)。最常被认为是病因的是假牙不合适导致口腔疼痛,药物及可能的口腔真菌感染导致口干。在1(不重要)至7(非常重要)的李克特量表上,患者认为口腔疼痛和口干症状相对于他们经历的其他症状或问题的重要性平均值分别为4.4±标准差1.84和3.6±标准差1.67。口干比口腔疼痛报告得更频繁。口腔疼痛强度的平均评分高于口干,尽管相对于当时经历的其他症状或问题,两者对患者来说都具有中等重要性。患者倾向于少报口腔疼痛和口干情况,而医生对这类主诉的处理往往不够充分。

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