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中度化疗引起的口腔黏膜炎患者:使用低强度激光的疼痛治疗。

Patients with moderate chemotherapy-induced mucositis: pain therapy using low intensity lasers.

作者信息

Nes A G, Posso M B S

机构信息

Buskerud University, Drammen, Norway.

出版信息

Int Nurs Rev. 2005 Mar;52(1):68-72. doi: 10.1111/j.1466-7657.2004.00401.x.

Abstract

BACKGROUND

Intensive cancer therapy normally affects malignant and normal cells with high replication rates. Cells in the gastrointestinal tract are therefore commonly affected by cytotoxins. This often results in the development of chemotherapy-induced oral mucositis (COM). COM is the inflammatory response of the oral mucous membrane to the chemotherapy drugs. Low level laser therapy (LLLT) has proved to be effective in treating and repairing biologically damaged tissue and to reduce pain. LLLT has also proven to be an efficient method for the prevention of oral mucositis.

OBJECTIVE

To investigate the effect of LLLT on pain relief among patients who have developed COM.

METHOD

The study was performed as a clinical test with a sample consisting of 13 adult patients receiving oncology treatment. The patients were treated during a 5-day period, and the pain was measured before and after each laser application. The laser used was an AsGaAl, with a wavelength of 830 nm and a potency of 250 mW. The energy given was 35 J cm(-2).

ANALYSIS

The results were analysed using the Wilcoxon test.

RESULTS

There was a significant (P = 0.007) 67% decrease in the daily average experience of pain felt before and after each treatment, confirming that LLLT can relieve pain among patients who have developed COM.

STUDY LIMITATIONS

The low number of COM patients at the hospital did not allow a control group to be included in the study, and therefore the results contain a potential placebo effect. IMPLICATIONS FOR NURSING CARE: The most important benefit the authors consider to be the value for the patients of better and quicker treatment with a drastic reduction in painful mucositis.

摘要

背景

强化癌症治疗通常会影响具有高复制率的恶性和正常细胞。因此,胃肠道中的细胞通常会受到细胞毒素的影响。这常常导致化疗引起的口腔黏膜炎(COM)的发生。COM是口腔黏膜对化疗药物的炎症反应。低强度激光疗法(LLLT)已被证明在治疗和修复生物受损组织以及减轻疼痛方面是有效的。LLLT也已被证明是预防口腔黏膜炎的一种有效方法。

目的

研究LLLT对已发生COM的患者缓解疼痛的效果。

方法

该研究作为一项临床试验进行,样本包括13名接受肿瘤治疗的成年患者。患者在5天内接受治疗,每次激光照射前后测量疼痛程度。使用的激光是砷镓铝激光,波长为830nm,功率为250mW。给予的能量为35J/cm²。

分析

结果采用威尔科克森检验进行分析。

结果

每次治疗前后每日平均疼痛体验显著降低(P = 0.007),降幅达67%,证实LLLT可缓解已发生COM的患者的疼痛。

研究局限性

医院中COM患者数量较少,无法在研究中纳入对照组,因此结果可能存在安慰剂效应。对护理的启示:作者认为最重要的益处是对患者而言能更好、更快地进行治疗,同时显著减轻疼痛性黏膜炎。

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