综合口腔护理方案对头颈部癌症放疗患者口腔健康和生活质量的影响：一项准实验性病例对照研究。

The effect of comprehensive oral care program on oral health and quality of life in patients undergoing radiotherapy for head and neck cancer: A quasi-experimental case-control study.

机构信息

Department of Preventive and Social Dentistry, Seoul National University School of Dentistry.

Dental Research Institute, Seoul National University.

出版信息

Medicine (Baltimore). 2021 Apr 23;100(16):e25540. doi: 10.1097/MD.0000000000025540.

DOI:10.1097/MD.0000000000025540

PMID:33879699

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8078395/

Abstract

OBJECTIVES

The purpose of this study is to investigate the effect of the comprehensive oral care program on oral health status and symptoms in head and neck cancer (HNC) patients undergoing radiotherapy.

METHODS

This was a quasi-experimental study using a non-equivalent control group in non-synchronized design. All participants including control and experimental group were asked for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 (EORTC QLQ-H&N35) and given an oral health education 4 times at baseline, immediate postradiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy. In each visit except for final, the experimental group was given fluoride varnish application and fluoride mouth rinsing solution for daily use. Oral health examination for dental caries, plaque score (PS), bleeding on probing (BOP), and salivary flow rate was performed in baseline and 6 months after radiotherapy. Statistical analyses were done by paired t-tests and mixed ANCOVA repeated-measures analysis.

RESULTS

From November 1, 2013 to October 31, 2015, a total 61 patients undergoing radiotherapy for HNC cancer were enrolled (30 in control and 31 in experimental groups). Decrease in salivary flow rate was comparable between 2 groups. Dental caries increased in control group (P = .006); PS and BOP were decreased in experimental group (P < .001 and .004, respectively). Experimental group showed lower swallowing, speech problems, and less sexuality scores in EORTC QLQ-H&N35 than control group.

CONCLUSION

We found improvement in oral health and the quality of life in HNC patients with comprehensive oral care intervention by dental professionals. Communicating and cooperating between the healthcare and dental professionals is needed to raise the quality of health care services for HNC patients receiving radiotherapy.

摘要

目的

本研究旨在探讨综合口腔护理方案对头颈部癌症（HNC）放疗患者口腔健康状况和症状的影响。

方法

这是一项使用非同步设计的准实验研究，采用非均等对照组。所有参与者（包括对照组和实验组）均被要求填写欧洲癌症研究与治疗组织生活质量问卷头颈部 35 项（EORTC QLQ-H&N35），并在基线、放疗即刻后、放疗后 3 个月和放疗后 6 个月接受 4 次口腔健康教育。在每次访问中（除最后一次外），实验组给予氟化物漆应用和氟化物漱口液供日常使用。在基线和放疗后 6 个月进行口腔健康检查，评估龋齿、菌斑指数（PS）、探诊出血（BOP）和唾液流率。采用配对 t 检验和混合重复测量方差分析进行统计分析。

结果

2013 年 11 月 1 日至 2015 年 10 月 31 日，共纳入 61 例接受 HNC 癌症放疗的患者（对照组 30 例，实验组 31 例）。两组唾液流率下降无差异。对照组龋齿增加（P =.006）；实验组 PS 和 BOP 降低（P ＜.001 和 P ＜.004）。实验组 EORTC QLQ-H&N35 的吞咽、言语问题和性功能评分均低于对照组。