Buchsel Patricia C
Seattle University College of Nursing, 18503 SE 64th Way, Issaquah, WA 98027, USA.
Expert Opin Drug Metab Toxicol. 2008 Nov;4(11):1449-54. doi: 10.1517/17425255.4.11.1449.
Painful oral lesions in patients with cancer, HIV or aphthous ulcers can cause significant pain and discomfort. Those with oral mucositis (OM) resulting from high-dose chemotherapy or irradiation are the most at risk for painful lesions that lead to significant morbidity and mortality, decreased quality of life and increased economic costs. Numerous approaches have been taken to prevent and treat OM in the cancer patient but this condition remains a significant obstacle to cancer therapy. Small studies have been done in healing oral lesions arising from laser surgery and in wound healing but research is needed to support the use of polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair) in these clinical setting.
The purpose of this paper is to review the benefit of polyvinylpyrrolidone-sodium hyaluronate gel, a topical oral mucosal barrier gel to prevent or diminish the pain of OM and other oral lesions.
Primary resources in peer-reviewed journals, chapters in recognized textbooks and information from international and national oncology and dental medicine scientific meetings.
Oncology patients receiving high-dose immunosuppressive therapy are the most at risk with painful OM. Current prevention and treatment options for OM have limited effectiveness. Although opioids are available for pain management, novel agents, to be used alone or in combination with other proven measures to decrease the severity and duration of OM, are emerging. Clinical studies in the use of polyvinylpyrrolidone-sodium hyaluronate to reduce the pain or disruption to the oral mucosa has merit. Few clinical trials or main publications have supported the use of this product. Robust randomized trials are needed to further support the clinical utility of this agent.
癌症、艾滋病毒患者或患有口腔溃疡的患者出现的口腔疼痛性病变会导致严重的疼痛和不适。因高剂量化疗或放疗导致口腔黏膜炎（OM）的患者最易出现疼痛性病变，这些病变会导致严重的发病率和死亡率、生活质量下降以及经济成本增加。已经采取了多种方法来预防和治疗癌症患者的口腔黏膜炎，但这种情况仍然是癌症治疗的重大障碍。在激光手术引起的口腔病变愈合以及伤口愈合方面已经进行了一些小型研究，但需要开展研究以支持在这些临床环境中使用聚乙烯吡咯烷酮 - 透明质酸钠凝胶（Gelclair）。
本文旨在综述聚乙烯吡咯烷酮 - 透明质酸钠凝胶（一种局部口腔黏膜屏障凝胶）预防或减轻口腔黏膜炎及其他口腔病变疼痛的益处。
同行评审期刊中的原始资料、知名教科书中的章节以及国际和国家肿瘤学与牙科医学科学会议的信息。
接受高剂量免疫抑制治疗的肿瘤患者患疼痛性口腔黏膜炎的风险最高。目前口腔黏膜炎的预防和治疗选择效果有限。虽然阿片类药物可用于疼痛管理，但正在出现单独使用或与其他已证实措施联合使用以降低口腔黏膜炎严重程度和持续时间的新型药物。使用聚乙烯吡咯烷酮 - 透明质酸钠减轻口腔黏膜疼痛或损伤的临床研究具有价值。很少有临床试验或主要出版物支持使用该产品。需要进行有力的随机试验以进一步支持该药物的临床实用性。
