A Pilot Randomized Controlled Trial of an Oral Care Intervention to Reduce Mucositis Severity in Stem Cell Transplant Patients
A Pilot Randomized Controlled Trial of an Oral Care Intervention to Reduce Mucositis Severity in Stem Cell Transplant Patients
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DOI：
10.1016/j.jpainsymman.2011.08.012
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发表时间：
2012-07-01
影响因子：
4.7
通讯作者：
Howell, Doris
中科院分区：
文献类型：
--
作者：
Salvador, Prisco;Azusano, Cristina;Howell, Doris
上下文口腔黏膜炎仍然是自体干细胞移植（ASCT）的一个重要问题。该试验评估了口腔冷冻治疗加口腔护理方案在降低ASCT患者口腔粘膜炎严重程度方面的有效性。入院接受ASCT的患者被随机分配到实验组（n = 23）或常规护理组（n = 23）。所有参与者都接受了良好口腔卫生原则和口腔自我护理技能培训的信息。实验组的患者接受了60分钟的口腔冷冻疗法。在第1、3、6、9和12天测量口腔粘膜炎严重程度的主要结局和粘膜炎相关疼痛以及食物和液体的功能性摄入的次要结局。住院时间由出院日至入院倒计时确定。对60分钟冷冻疗法的耐受性和可接受性以及口腔护理方案的频率的感知也进行了评估。在六个月内，在研究中心招募了48名患者。实验组口腔粘膜炎严重程度的总体平均值（SE）显著低于对照组：0.43（0.12）vs. 1.14（0.12）; P < 0.001，0-4量表。实验组的总体平均（SE）粘膜炎相关疼痛评分也显著低于对照组：0.30（0.23）vs. 1.64（0.24）; P < 0.001，在0-10量表上。口腔冷冻加口腔护理方案似乎是有益的，在减少严重程度的粘膜炎相比，口腔护理方案单独。J Pain Symptom Manage 2012;44：64-73. (C)2012年美国癌症疼痛缓解委员会出版的爱思唯尔公司。All rights reserved.
Context. Oral mucositis remains a significant problem in autologous stem cell transplantation (ASCT).Objectives. This pilot trial assessed the effectiveness of oral cryotherapy plus an oral care protocol in reducing oral mucositis severity in ASCT patients.Methods. Patients admitted for ASCT were randomly allocated to either the experimental arm (n = 23) or usual care (n = 23). All participants received information on principles of good oral hygiene and skills training in oral self-care. Patients in the experimental arm had a 60-minute regimen of oral cryotherapy. The primary outcome of oral mucositis severity and secondary outcomes of mucositis-related pain and functional intake of food and fluids were measured at Days - 1, 3, 6, 9, and 12. Length of hospital stay was determined by counting backward from discharge day to admission. Perception of tolerability and acceptability of the 60-minute cryotherapy and frequency of the oral care regimen also were assessed.Results. Forty-eight patients were recruited at the study site in six months. The overall mean (SE) of oral mucositis severity for the experimental arm was significantly lower than that for the control group: 0.43 (0.12) vs. 1.14 (0.12); P < 0.001, on a 0-4 scale. The overall mean (SE) mucositis-related pain score for the experimental arm also was significantly lower than that for the control group: 0.30 (0.23) vs. 1.64 (0.24); P < 0.001, on a 0-10 scale.Conclusion. Oral cryotherapy plus an oral care protocol appears to be beneficial in reducing severity of mucositis compared with an oral care protocol alone. J Pain Symptom Manage 2012;44:64-73. (C) 2012 U.S. Cancer Pain Relief Committee Published by Elsevier Inc. All rights reserved.