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消化系统肿瘤患者围手术期口腔环境状况

Status of the oral environment in patients with digestive system tumors during the perioperative period.

作者信息

Zhang Hongyu, Liu Fang, Zhang Nian, An Jing

机构信息

Department of Stomatology, The Seventh Affiliated Hospital, Xinjiang Medical University Urumqi 830028, Xinjiang, China.

Department of Stomatology, The Seventh Medical Center of PLA General Hospital Beijing 100007, China.

出版信息

Am J Transl Res. 2024 Jul 15;16(7):3385-3394. doi: 10.62347/NLSQ6388. eCollection 2024.

Abstract

BACKGROUND

Surgery is an important treatment modality for patients with digestive system tumors, and perioperative management is crucial for the patients' recovery and quality of life. During the perioperative period, significant changes can occur in the oral environment of patients, such as dry mouth, mucosal ulceration, and oral infections. These issues not only cause discomfort to the patients but may also affect postoperative recovery and treatment outcomes. Therefore, it is essential to investigate and analyze the oral environment during the perioperative period in patients with digestive system tumors.

AIM

This study aims to investigate the oral health status in patients with digestive system tumors during the perioperative period and analyze the influencing factors.

METHODS

In this retrospective study, a total of 242 patients with digestive system tumors admitted to The Seventh Affiliated Hospital, Xinjiang Medical University from September 2021 to June 2023 were selected as the study population (patient group). During the same period, 245 healthy volunteers who received oral examinations were selected as the healthy group. The study compared the oral hygiene environment of the two groups, including the Dental Plaque Index (DI), Calculus Index (CI), and Periodontal Disease Index (PDI). Measurements were taken at admission (T0), 1 hour before surgery (T1), and 3 days after surgery (T2). Based on the PDI index, the patient group was divided into a periodontal disease group (PDI ≥ 3, n = 196) and a periodontal healthy group (PDI < 3, n = 46). The risk factors for the development of periodontal disease in digestive system tumor patients were analyzed, considering variables such as gender, age, BMI, smoking status, alcohol consumption frequency, monthly income, tumor type, oral self-care habits, low-grade inflammation, and nutritional status.

RESULTS

The DI, CI and PDI indexes in patient group were higher than those in healthy group (3.23±0.64 vs 1.46±0.43, 1.92±0.46 vs 1.21±0.41, 3.83±0.79 vs 2.65±0.69, all < 0.05). DI index, CI index and PDI index at T1 and T2 were significantly lower than those at T0 ( < 0.05), and these indices at T2 were slightly higher than T1, but the difference was not statistically significant (all > 0.05). Multivariate analyses identified high levels of high-sensitivity C-Reactive Protein [OR: 15.070 (1.611-140.951)], low levels of hemoglobin [OR: 0.239 (0.058-0.981)], and presence of dental caries [OR: 246.737 (1.160-52464.597)] as risk factors associated with periodontal disease in patients with digestive system tumors.

CONCLUSION

It is important to enhance the attention and management of the oral environment during the perioperative period for patients with digestive system tumors.

摘要

背景

手术是消化系统肿瘤患者的重要治疗方式,围手术期管理对患者的康复及生活质量至关重要。在围手术期,患者的口腔环境会发生显著变化,如口干、黏膜溃疡和口腔感染。这些问题不仅给患者带来不适,还可能影响术后恢复及治疗效果。因此,对消化系统肿瘤患者围手术期的口腔环境进行调查分析很有必要。

目的

本研究旨在调查消化系统肿瘤患者围手术期的口腔健康状况并分析影响因素。

方法

在这项回顾性研究中,选取2021年9月至2023年6月在新疆医科大学第七附属医院收治的242例消化系统肿瘤患者作为研究人群(患者组)。同期选取245例接受口腔检查的健康志愿者作为健康组。比较两组的口腔卫生环境,包括牙菌斑指数(DI)、牙结石指数(CI)和牙周疾病指数(PDI)。在入院时(T0)、手术前1小时(T1)和术后3天(T2)进行测量。根据PDI指数,将患者组分为牙周疾病组(PDI≥3,n = 196)和牙周健康组(PDI<3,n = 46)。分析消化系统肿瘤患者发生牙周疾病的危险因素,考虑性别、年龄、BMI、吸烟状况、饮酒频率、月收入、肿瘤类型、口腔自我护理习惯、低度炎症和营养状况等变量。

结果

患者组的DI、CI和PDI指数高于健康组(3.23±0.64 vs 1.46±0.43,1.92±0.46 vs 1.21±0.41,3.83±0.79 vs 2.65±0.69,均P<0.05)。T1和T2时的DI指数、CI指数和PDI指数显著低于T0时(P<0.05),且T2时这些指数略高于T1,但差异无统计学意义(均P > 0.05)。多因素分析确定高敏C反应蛋白水平高[比值比(OR):15.070(1.611 - 140.951)]、血红蛋白水平低[OR:0.239(0.058 - 0.981)]和存在龋齿[OR:246.737(1.160 - 52464.597)]是消化系统肿瘤患者牙周疾病的相关危险因素。

结论

加强对消化系统肿瘤患者围手术期口腔环境的关注和管理很重要。

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