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儿科肿瘤住院患者口腔黏膜炎的患病率及危险因素调查:一项前瞻性研究

The Prevalence and Investigation of Risk Factors of Oral Mucositis in a Pediatric Oncology Inpatient Population; a Prospective Study.

作者信息

Allen Gabrielle, Logan Richard, Revesz Tom, Keefe Dorothy, Gue Sam

机构信息

Departments of Paediatric Dentistry.

Adelaide Dental School.

出版信息

J Pediatr Hematol Oncol. 2018 Jan;40(1):15-21. doi: 10.1097/MPH.0000000000000970.

Abstract

BACKGROUND

Oral mucositis can be a frequent and severe complication of chemotherapy in children. It can result in pain, infection, depression, prolonged admission, treatment delays, increase in patient morbidity, and increased costs.

AIM

To record the prevalence and severity of oral mucositis among inpatients and explore the relationship of risks factors and the development of oral mucositis.

DESIGN

During an 18-month period 643 clinical inpatient assessments were completed on 73 children who were admitted and had received chemotherapy in the last 14 days.

RESULTS

There were 43 episodes of oral mucositis in 31 children; 42.5% of the inpatient population. World Health Organization assessment identified 32.6% of episodes were grade 1, 34.9% grade 2, 14.0% grade 3, and 18.6% grade 4. Analysis revealed significant associations between patient diagnosis (P<0.0001), chemotherapy cycles (P<0.0001), day 8 and 9 of the chemotherapy cycle (P<0.05), and neutropenia (P<0.0001) and oral mucositis. Children had increased length of admission with increasing severity of oral mucositis (P=0.0005).

CONCLUSIONS

The prevalence of oral mucositis was 42.5% among inpatients and admission length was increased with increasing severity. Patient diagnosis, chemotherapy treatment block, day of chemotherapy cycle, and neutropenic status were shown to influence the risk of developing oral mucositis.

摘要

背景

口腔黏膜炎可能是儿童化疗常见且严重的并发症。它可导致疼痛、感染、抑郁、住院时间延长、治疗延迟、患者发病率增加以及费用上升。

目的

记录住院患者口腔黏膜炎的患病率和严重程度,并探讨危险因素与口腔黏膜炎发生发展的关系。

设计

在18个月期间,对73名在过去14天内入院并接受化疗的儿童完成了643次临床住院评估。

结果

31名儿童出现43次口腔黏膜炎发作;占住院患者的42.5%。世界卫生组织评估确定32.6%的发作属于1级,34.9%为2级,14.0%为3级,18.6%为4级。分析显示患者诊断(P<0.0001)、化疗周期(P<0.0001)、化疗周期的第8天和第9天(P<0.05)以及中性粒细胞减少(P<0.0001)与口腔黏膜炎之间存在显著关联。口腔黏膜炎严重程度增加,儿童住院时间延长(P=0.0005)。

结论

住院患者口腔黏膜炎患病率为42.5%,住院时间随严重程度增加而延长。患者诊断、化疗疗程、化疗周期天数和中性粒细胞减少状态被证明会影响发生口腔黏膜炎的风险。

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