两种不同口腔卫生方案对接受造血干细胞移植的儿科患者口腔黏膜炎发生率和严重程度的影响：一项前瞻性干预研究。
The efficacy of two different oral hygiene regimens on the incidence and severity of oral mucositis in pediatric patients receiving hematopoietic stem cell transplantation: A prospective interventional study.
作者信息
Mubaraki Sarah, Pani Sharat Chandra, Alseraihy Amal, Abed Hassan, Alkhayal Zikra
机构信息
Department of Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia.
Department of Pediatric Dentistry and Orthodontics, The University of Western Ontario, London, Canada.
出版信息
Spec Care Dentist. 2020 Nov;40(6):566-573. doi: 10.1111/scd.12525. Epub 2020 Sep 21.
AIMS
This prospective interventional study aimed to assess the efficacy of supersaturated calcium phosphate rinse and the use of an extra-soft toothbrush twice a day when added to the existing oral hygiene protocol regimen (0.12% chlorhexidine gluconate + 3% sodium bicarbonate + nystatin 5000 U/mL) in reducing the severity of oral mucositis among pediatric patients receiving chemotherapy for the hematopoietic stem cell transplant.
METHODS
Forty-five patients that received chemotherapy for the hematopoietic stem cell transplant were randomly allocated to three groups of 15 patients each. Group A was advised to follow the existing oral hygiene protocol regimen (Control), group B was advised to brush their teeth twice daily using an extra-soft toothbrush and to follow the control regimen, and lastly group C was advised to use supersaturated calcium phosphate rinse and to follow the control regimen. Oral mucositis was recorded according to World Health Organization criteria from the day of admission (day 1) to the day of discharge (day 28). The incidence of oral mucositis between the three groups was compared using the Kruskall-Wallis test while the severity of oral mucositis between the three groups was compared using a one-way ANOVA test.
RESULTS
The results of the study showed no significant difference in the incidence of oral mucositis between the three groups; however, there was a lower severity of oral mucositis in the supersaturated calcium phosphate rinse group when compared to the control group or the group who used an extra-soft toothbrush with the control regimen.
CONCLUSION
Although marginally fewer cases and lower severity of oral mucositis was observed in the group using supersaturated calcium phosphate rinse, the lack of statistical significance suggests that the evidence for their use is not conclusive. The results of this study also showed that the introduction of an extra-soft toothbrush into the oral hygiene regimen did not significantly reduce the incidence of oral mucositis and may actually be responsible for an increase in the severity of oral mucositis.
目的
这项前瞻性干预性研究旨在评估在现有的口腔卫生方案（0.12%葡萄糖酸氯己定+3%碳酸氢钠+5000 U/mL制霉菌素）基础上，添加过饱和磷酸钙漱口液以及每天使用两次超软牙刷，对接受造血干细胞移植化疗的儿科患者口腔黏膜炎严重程度的影响。
方法
45例接受造血干细胞移植化疗的患者被随机分为三组，每组15例。A组遵循现有的口腔卫生方案（对照组），B组每天使用超软牙刷刷牙两次并遵循对照组方案，最后C组使用过饱和磷酸钙漱口液并遵循对照组方案。从入院当天（第1天）到出院当天（第28天），根据世界卫生组织标准记录口腔黏膜炎情况。使用Kruskal-Wallis检验比较三组之间口腔黏膜炎的发生率，使用单向方差分析检验比较三组之间口腔黏膜炎的严重程度。
结果
研究结果显示，三组之间口腔黏膜炎的发生率没有显著差异；然而，与对照组或使用超软牙刷并遵循对照组方案的组相比，过饱和磷酸钙漱口液组的口腔黏膜炎严重程度较低。
结论
尽管使用过饱和磷酸钙漱口液的组中观察到口腔黏膜炎的病例略少且严重程度较低，但缺乏统计学意义表明其使用证据并不确凿。本研究结果还表明，在口腔卫生方案中引入超软牙刷并不能显著降低口腔黏膜炎的发生率，实际上可能导致口腔黏膜炎严重程度增加。
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