背景:在晚期癌症患者中,口试,口腔护理,口头复查至关重要。尽管口腔症状是临终患者的主要主诉,很少有研究关注这些患者的口腔护理。在这项研究中,检查了临终患者口腔症状与口腔干燥之间的关系,并量化了专业牙医口腔护理干预后口腔状况的改善。
方法:这项前瞻性干预研究包括27名临终关怀病房晚期癌症患者。每天早上进行专业口腔护理,通过比较干预前后的口腔状况来评估口腔状况的改善情况。使用口腔健康评估工具(OHAT)和口腔评估指南进行口腔评估。通过口腔干燥的临床诊断分类和口腔保湿装置评估口腔干燥。使用细菌计数器评估口腔清洁度,并收集舌涂片进行念珠菌检查;此外,记录口腔功能。
结果:口腔黏膜炎的存在与严重口腔干燥密切相关(比值比[OR]=14.93;95%置信区间[CI]:1.95-114.38)。口腔碎片保留水平与口腔干燥程度显着相关(OR=15.97;95%CI:2.06-123.72)。得分较高的组(OHAT>8),这代表了糟糕的口腔条件,显示严重的口腔干燥(OR=17.97;95%CI:1.45-223.46)。总OHAT评分(中位数:7vs2)和其他亚组(唇,舌头,牙龈和组织,唾液,干预后口腔清洁度显着下降。此外,粘膜炎的发生率(47.1%vs0%),念珠菌感染率(68.8%和43.8%),口腔干燥自我感觉(63.6%vs9.1%),严重口腔碎片(52.9%vs11.8%)显著减少。
结论:适当的口腔护理可以改善口腔健康和卫生,降低粘膜炎的发生率,减少口腔干燥的感觉,增加口腔水分,并减少临终患者口腔感染的机会。日常口腔护理是必要的,可以缓解口腔不适,增加食物摄入量,并增加临终患者与其家人之间沟通的机会。
BACKGROUND: In end-of-life patients with advanced cancers, oral examination, oral care, and oral re-examination are crucial. Although oral symptoms are among the major complaints of end-of-life patients, few studies have focused on oral care in these patients. In this study, the association between oral symptoms and oral dryness among end-of-life patients was examined, and improvement of oral conditions after oral care interventions by a professional dentist was quantified.
METHODS: This prospective intervention study included 27 terminally ill patients with advanced cancers in a hospice ward. Professional oral care was administered every morning, and the improvement of oral conditions was assessed by comparing oral conditions before and after the intervention. Oral assessment was performed using the Oral Health Assessment Tool (OHAT) and Oral Assessment Guide. Oral dryness was evaluated through Clinical Diagnosis Classification of oral dryness and an oral moisture device. Oral cleanliness was evaluated using a bacterial counter, and tongue smears were collected for Candida examination; furthermore, oral function was recorded.
RESULTS: The presence of oral mucositis was closely associated with severe oral dryness (odds ratio [OR] = 14.93; 95% confidence interval [CI]: 1.95-114.38). The level of oral debris retention was significantly related to the degree of oral dryness (OR = 15.97; 95% CI: 2.06-123.72). The group with higher scores (OHAT > 8), which represent poor oral conditions, showed severe oral dryness (OR = 17.97; 95% CI: 1.45-223.46). Total OHAT scores (median: 7 vs 2) and those of other subgroups (lip, tongue, gums and tissues, saliva, and oral cleanliness showed a significant decrease after the intervention. Furthermore, the occurrence of mucositis (47.1% vs 0%), candidiasis rate (68.8% vs 43.8%), oral dryness self-sensation (63.6% vs 9.1%), and severe oral debris (52.9% vs 11.8%) decreased significantly.
CONCLUSIONS: Proper oral care can improve oral health and hygiene, reduce the rate of mucositis, reduce the sensation of oral dryness, increase oral moisture, and reduce the chances of oral infections among end-of-life patients. Daily oral care is necessary and can alleviate oral discomfort, increase food intake, and increase the chances of communication between end-of-life patients and their families.