Effects of the Intensive Nursing Plan on Prevention of the Oral Mucositis Caused by Chemotherapy in Acute Leukemia
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摘要:
目的 探讨急性白血病化疗所致口腔黏膜炎的集束化护理方案构建及防治效果。 方法 选取2019年10月至2020年10月在昆明医科大学第一附属医院血液科的100例初诊急性白血病化疗患者，按随机数表法分为观察组、对照组，各50例。对照组给予常规预防性护理，观察组在对照组基础上给予集束化护理。于护理干预结束后对两组患者的一般资料（干预前）、口腔炎症感染发生率、口腔黏膜炎每日自评问卷（OMDQ）评分、心理状态评分、护理满意度等进行评估对比。 结果 两组患者一般资料比较，差异无统计学意义（P > 0.05）。护理干预后观察组患者的口腔黏膜感染率为32.00%（16/50），低于对照组患者为52.00%（26/50），组间对比差异有统计学意义（P < 0.05）。护理干预后观察组OMDQ评分、焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均低于对照组（P < 0.05）。观察组护理满意度为90.00%（45/50），高于对照组为74.00%（37/50），组间对比有显著性差异（P < 0.05）。 结论 通过构建集束化护理干预方案对急性白血病化疗所致口腔黏膜炎的护理干预效果良好，降低口腔炎症感染发生率，改善患者的生活质量评分、不良心理状态，提高患者的护理满意度，值得临床推荐。 Abstract:Objective To study the construction, the prevention and treatment effect of the intensive nursing plan of oral mucositis caused by chemotherapy in acute leukemia. Methods 100 patients newly diagnosed as acute leukemia chemotherapy in the Dept. of Hematology, the First Affiliated Hospital of Kunming Medical University were selected from October 2019 to October 2020 to carry out this study. According to the random number table method, they were divided into the observation group and the control group, with 50 cases in each.The control group was given routine preventive care, and the observation group was given intensive care on the basis of the control group. After the nursing intervention, the general data（before the intervention）, the incidence of oral inflammation infection, the OMDQ score, the psychological state score and the nursing satisfaction of the two groups were evaluated and compared. Results There was no significant difference between the two groups（P > 0.05）. After the nursing intervention, the infection rate of oral mucosa in the observation group was 32.00%（16/50）, which was lower than that in the control group 52.00%（26/50）. The difference between the two groups was statistically significant（P < 0.05）. After the nursing intervention, the scores of OMDQ, SAS and SDS in the observation group were lower than those in the control group（P < 0.05）. The nursing satisfaction of the observation group was 90.00%（45/50）, which was higher than that of the control group 74.00%（37/50）. There was significant difference between the two groups（P < 0.05）. Conclusion Through the construction of cluster nursing intervention program, the effect of nursing intervention on the oral mucositis caused by chemotherapy of acute leukemia is good, which can reduce the incidence of patients with oral inflammation infection, improve the patients' quality of life score, bad psychological state, and improve the patients' nursing satisfaction. It is worthy of clinical recommendation. -
Key words:
- Acute leukemia /
- Chemotherapy /
- Oral mucositis /
- Cluster nursing program /
- Psychological score /
- Nursing satisfaction
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表 1 两组患者性别、年龄、住院时间OAG评分及基础疾病比较[n，（
$ \bar x \pm s$ ）]Table 1. Comparison of general information of the two groups of patients[n，（
$ \bar x \pm s $ ）]组别 n 性别 年龄（岁） 住院时间（d） OAG评分（分） 基础疾病 男 女 高血压 高血脂 糖尿病 观察组 50 27 23 51.09 ± 10.23 23.27 ± 5.84 9.12 ± 3.04 8 9 6 对照组 50 22 28 51.97 ± 10.61 24.32 ± 5.89 9.59 ± 3.12 10 7 8 t/χ2 − 1.001 0.422 0.895 0.763 0.271 0.298 0.332 P − 0.317 0.674 0.373 0.447 0.603 0.585 0.564 
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表 2 口腔黏膜感染发生率对比[n（%）]
Table 2. Comparison of incidence of oral mucosal infection[n（%）]
组别 例数 0级 1级 2级 3级 4级 总感染率 观察组 50 34（68.00） 7（14.00） 5（10.00） 3（6.00） 1（2.00） 16（32.00） 对照组 50 26（52.00） 9（18.00） 8（16.00） 6（12.00） 3（6.00） 26（52.00） χ2 4.105 P 0.043
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表 3 OMDQ、SAS、SDS评分对比[（
$\bar x \pm s$ ），分]Table 3. Comparison of OMDQ、SAS、SDS scores[（
$\bar x \pm s$ ），Scores]组别 OMDQ评分 SAS评分 SDS评分 干预前 干预后 干预前 干预后 干预前 干预后 观察组（n = 50） 25.17 ± 3.98 11.03 ± 2.07 55.46 ± 6.13 27.83 ± 4.11 51.06 ± 5.59 22.43 ± 4.76 对照组（n = 50） 25.91 ± 4.03 13.96 ± 2.13 54.32 ± 6.09 30.92 ± 4.45 50.27 ± 5.76 26.74 ± 4.92 t值 0.924 6.975 0.933 3.607 0.696 4.452 P 0.358 < 0.001* 0.353 < 0.001* 0.488 < 0.001* 注：*P < 0.05。
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表 4 两组患者护理满意度对比[n（%）]
Table 4. Comparison of nursing satisfaction between the two groups of patients[n（%）]
组别 n 非常满意 满意 一般 不满意 总满意度 观察组 50 26（52.00） 12（24.00） 7（14.00） 5（10.00） 45（90.00） 对照组 50 18（36.00） 11（22.00） 8（16.00） 13（26.00） 37（74.00） χ2 4.336 P 0.037
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