Clinical observation of tongue coating of perioperative patients: factors related to the number of bacteria on the tongue before and after surgery
Clinical observation of tongue coating of perioperative patients: factors related to the number of bacteria on the tongue before and after surgery
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DOI：
10.1186/s12903-018-0689-x
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发表时间：
2018-12-20
期刊：
影响因子：
2.9
通讯作者：
Umeda, Masahiro
中科院分区：
文献类型：
--
作者：
Funahara, Madoka;Yanamoto, Souichi;Umeda, Masahiro
背景 据报道，舌苔量的增加与老年人唾液中细菌数量的增加和吸入性肺炎有关。然而，舌苔对于预防接受重大肿瘤或心脏手术的患者术后并发症的影响尚未得到充分记录。本研究的目的是调查手术前后舌头上的细菌数量及其影响因素。方法以长崎大学医院全身麻醉下接受肿瘤或心脏手术的54例患者为研究对象。检查各种人口统计学、肿瘤相关、治疗相关因素以及舌头和唾液中的细菌数量，并通过Mann-Whitney U检验、Spearman等级相关系数或多元回归分析它们之间的关系。结果术前，没有显着因素与舌头上的细菌数量相关，并且舌头上的细菌数量与唾液中的细菌数量之间没有关系。术后第二天，舌头上的细菌增加，通过单变量分析，将性别、牙周袋深度、喂养情况、牙菌斑、失血量和唾液中的细菌与舌头上的细菌相关。多变量分析显示，喂养条件和牙菌斑数量与细菌数量相关。结论舌头上细菌数量的增加与喂养条件和牙菌斑数量相关。需要进一步的研究来阐明牙科涂层在接受肿瘤或心脏手术的患者围手术期口腔管理中的临床意义。
BackgroundIncreased amount of tongue coating has been reported to be associated with increased bacteria count in the saliva and aspiration pneumonia in elderly people. However, the implications of tongue coating for prevention of postoperative complications in patients undergoing major oncologic or cardiac surgery has not been well documented. The purpose of this study is to investigate the number of bacteria on the tongue before and after surgery and factors affecting it.MethodsFifty-four patients who underwent oncologic or cardiac surgery under general anesthesia at Nagasaki University Hospital were enrolled in the study. Various demographic, tumor-related, treatment-related factors, and the number of bacteria on the tongue and in the saliva were examined, and the relationship among them was analyzed by Mann-Whitney U test, Spearman rank correlation coefficient, or multiple regression.ResultsBefore surgery, no significant factors were correlated with the number of bacteria on the tongue, and there were no relationship between bacteria count on the tongue and that in the saliva. On the next day after surgery, bacteria on the tongue increased, and sex, periodontal pocket depth, feeding condition, dental plaque, blood loss, and bacteria in the saliva were correlated with bacteria on the tongue by a univariate analysis. A multivariate analysis showed that feeding condition, and amount of dental plaque were correlated with the number of bacteria.ConclusionsIncreased number of bacteria on the tongue was associated with feeding condition and amount of dental plaque. Further studies are necessary to clarify the clinical significance of dental coating in perioperative oral management of patients undergoing oncologic or cardiac surgery.