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COVID-19 患者在重症监护病房中的口腔病变和唾液改变:一项回顾性研究。

Oral lesions and saliva alterations of COVID-19 patients in an intensive care unit: A retrospective study.

机构信息

Hospital Israelita Albert Einstein, São Paulo, Brazil.

School of Dentistry, University of São Paulo, São Paulo, Brazil.

出版信息

Spec Care Dentist. 2022 Sep;42(5):494-502. doi: 10.1111/scd.12705. Epub 2022 Mar 3.

Abstract

To detect the type and frequency of oral lesions and clinical conditions suggestive of saliva alterations in COVID-19 patients in an intensive care unit (ICU), as well as to describe the patient´s management in each case METHODS: Information about oral conditions and mechanical ventilation was collected from oral medicine records of COVID-19 patients in an ICU (n = 519) RESULTS: From the total collected, 472 patients (90.9%) were examined by the oral medicine staff. In 242/472 patients (51.3%), alterations in the oral cavity were noted. The most frequent changes were mechanical trauma (18.1%, derived mainly from intubation), vascular/coagulation disturbances (24.1%, petechiae, bruises, varicoses, and oral bleeding), and saliva alterations (24.4%, dry mouth, and sialorrhea). Infectious lesions were mentioned in the oral medicine records (16.9%), most associated with a viral infection (15.7%), mainly herpesvirus. Improved oral change protocols included oral hygiene, use of specific medications, and laser therapy CONCLUSION: COVID-19 patients in the ICU often showed dryness in the oral and mucosa oral lesions related to vascular/coagulation disturbances, and mechanical trauma derived from orotracheal tube. An oral medicine staff must be aligned with the ICU multidisciplinary team to manage COVID-19 patients, as well as to establish diagnoses and oral cavity treatments.

摘要

目的

在重症监护病房(ICU)中检测 COVID-19 患者的口腔病变类型和频率,以及临床情况,这些情况提示唾液发生改变,并描述每个病例的患者管理情况。

方法

从 ICU 中 COVID-19 患者的口腔医学记录中收集有关口腔状况和机械通气的信息(n=519)。

结果

从所收集的总数中,有 472 名患者(90.9%)由口腔医学人员进行了检查。在 242/472 名患者(51.3%)中,口腔出现改变。最常见的变化是机械性创伤(18.1%,主要源于插管)、血管/凝血障碍(24.1%,表现为瘀点、瘀斑、静脉曲张和口腔出血)和唾液改变(24.4%,口干和流涎)。口腔医学记录中提到了感染性病变(16.9%),最常与病毒感染(15.7%)相关,主要是疱疹病毒。改进的口腔变化方案包括口腔卫生、使用特定药物和激光治疗。

结论

ICU 中的 COVID-19 患者经常出现口腔和口腔黏膜干燥以及与血管/凝血障碍和经口气管插管相关的机械性创伤引起的病变。口腔医学人员必须与 ICU 多学科团队合作,以管理 COVID-19 患者,并进行诊断和口腔治疗。

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