Sweeney M P, Bagg J, Baxter W P, Aitchison T C
Renfrewshire Healthcare NHS Trust, Dykebar Hospital, Paisley, U.K.
Oral Oncol. 1998 Mar;34(2):123-6. doi: 10.1016/s1368-8375(97)00076-6.
Xerostomia is common among patients with advanced cancer and is likely to contribute to oral disease. This study determined the prevalence of oral signs and symptoms among a group of 70 terminally ill cancer patients [25 male, 45 female; age range 42-88 (mean 66) years] complaining of oral dryness, and examined the associated oral microflora. Imprint cultures for yeasts, coliforms and staphylococci were collected from the tongue and, in denture wearers, from the plate and denture fitting surface. A swab was collected for culture of herpes simplex virus. 68 patients (97%) complained of oral dryness during the day and 59 patients (84%) complained of oral dryness at night. Oral soreness was reported by 22 patients (31%). 46 patients (66%) had difficulty talking and 36 (51%) reported difficulty eating. Of the 56 denture wearers, 40% complained of denture problems. On examination, 63 (90%) of the patients had clinically dry mouths. Oral mucosal abnormalities were detected in 45 patients (65%), most commonly erythema (20%), coated tongue (20%), atrophic glossitis (17%), angular cheilitis (11%) and pseudomembraneous candidosis (9%). 47 (67%) of the patients carried yeasts, 18 (26%) were carriers of Staphylococcus aureus and 13 (19%) carried coliforms. Herpes simplex virus was isolated from 5 patients, of whom 2 had herpetic stomatitis. Oral complications and abnormalities of the oral microflora can be detected among significant numbers of terminally ill cancer patients with xerostomia.
口干症在晚期癌症患者中很常见，且可能导致口腔疾病。本研究确定了一组70名主诉口腔干燥的晚期癌症患者（25名男性，45名女性；年龄范围42 - 88岁，平均66岁）的口腔体征和症状患病率，并检查了相关的口腔微生物群。从舌头采集酵母、大肠菌群和葡萄球菌的印迹培养物，对于佩戴假牙者，还从假牙托和假牙贴合面采集。采集拭子用于培养单纯疱疹病毒。68名患者（97%）白天主诉口腔干燥，59名患者（84%）夜间主诉口腔干燥。22名患者（31%）报告有口腔疼痛。46名患者（66%）说话困难，36名患者（51%）报告进食困难。在56名佩戴假牙者中，40%主诉有假牙问题。检查发现，63名患者（90%）临床诊断为口干。45名患者（65%）检测到口腔黏膜异常，最常见的是红斑（20%）、舌苔（20%）、萎缩性舌炎（17%）、口角炎（11%）和假膜性念珠菌病（9%）。47名患者（67%）携带酵母，18名患者（26%）是金黄色葡萄球菌携带者，13名患者（19%）携带大肠菌群。从5名患者中分离出单纯疱疹病毒，其中2名患有疱疹性口炎。在大量患有口干症的晚期癌症患者中可检测到口腔并发症和口腔微生物群异常。
