背景:手术是消化系统肿瘤患者的重要治疗方式,围手术期管理对患者的康复和生活质量至关重要。围手术期,患者口腔环境会发生显著变化,比如口干,粘膜溃疡,口腔感染。这些问题不仅会给患者带来不适,还会影响术后恢复和治疗效果。因此,对消化系统肿瘤患者围手术期口腔环境的调查与分析至关重要。
目的:本研究旨在调查消化系统肿瘤患者围手术期口腔健康状况并分析其影响因素。
方法:在这项回顾性研究中,第七附属医院收治的242例消化系统肿瘤患者,选取新疆医科大学2021年9月至2023年6月为研究人群(患者组)。在同一时期,选取接受口腔检查的健康志愿者245例作为健康组。研究比较两组口腔卫生环境,包括牙菌斑指数(DI),微积分指数(CI),和牙周病指数(PDI)。在入院时(T0)进行测量,手术前1小时(T1),和手术后3天(T2)。根据PDI指数,患者组分为牙周病组(PDI≥3,n=196)和牙周健康组(PDI<3,n=46).分析消化系统肿瘤患者发生牙周病的危险因素,考虑到性别等变量,年龄,BMI,吸烟状况,饮酒频率,月收入,肿瘤类型,口腔自我保健习惯,低度炎症,和营养状况。
结果:DI,患者组的CI和PDI指数高于健康组(3.23±0.64vs1.46±0.43,1.92±0.46vs1.21±0.41,3.83±0.79vs2.65±0.69,均P<0.05)。DI指数,T1和T2时的CI指数和PDI指数显著低于T0时(P<0.05),T2时各项指标均略高于T1,但差异均无统计学意义(均P>0.05)。多变量分析确定了高水平的高灵敏度C反应蛋白[OR:15.070(1.611-140.951)],低水平的血红蛋白[OR:0.239(0.058-0.981)],和龋齿的存在[OR:246.737(1.160-52464.597)]是与消化系统肿瘤患者牙周病相关的危险因素。
结论:对于消化系统肿瘤患者围手术期加强口腔环境的关注和管理是非常重要的。
BACKGROUND: Surgery is an important treatment modality for patients with digestive system tumors, and perioperative management is crucial for the patients\' recovery and quality of life. During the perioperative period, significant changes can occur in the oral environment of patients, such as dry mouth, mucosal ulceration, and oral infections. These issues not only cause discomfort to the patients but may also affect postoperative recovery and treatment outcomes. Therefore, it is essential to investigate and analyze the oral environment during the perioperative period in patients with digestive system tumors.
OBJECTIVE: This study aims to investigate the oral health status in patients with digestive system tumors during the perioperative period and analyze the influencing factors.
METHODS: In this retrospective study, a total of 242 patients with digestive system tumors admitted to The Seventh Affiliated Hospital, Xinjiang Medical University from September 2021 to June 2023 were selected as the study population (patient group). During the same period, 245 healthy volunteers who received oral examinations were selected as the healthy group. The study compared the oral hygiene environment of the two groups, including the Dental Plaque Index (DI), Calculus Index (CI), and Periodontal Disease Index (PDI). Measurements were taken at admission (T0), 1 hour before surgery (T1), and 3 days after surgery (T2). Based on the PDI index, the patient group was divided into a periodontal disease group (PDI ≥ 3, n = 196) and a periodontal healthy group (PDI < 3, n = 46). The risk factors for the development of periodontal disease in digestive system tumor patients were analyzed, considering variables such as gender, age, BMI, smoking status, alcohol consumption frequency, monthly income, tumor type, oral self-care habits, low-grade inflammation, and nutritional status.
RESULTS: The DI, CI and PDI indexes in patient group were higher than those in healthy group (3.23±0.64 vs 1.46±0.43, 1.92±0.46 vs 1.21±0.41, 3.83±0.79 vs 2.65±0.69, all P < 0.05). DI index, CI index and PDI index at T1 and T2 were significantly lower than those at T0 (P < 0.05), and these indices at T2 were slightly higher than T1, but the difference was not statistically significant (all P > 0.05). Multivariate analyses identified high levels of high-sensitivity C-Reactive Protein [OR: 15.070 (1.611-140.951)], low levels of hemoglobin [OR: 0.239 (0.058-0.981)], and presence of dental caries [OR: 246.737 (1.160-52464.597)] as risk factors associated with periodontal disease in patients with digestive system tumors.
CONCLUSIONS: It is important to enhance the attention and management of the oral environment during the perioperative period for patients with digestive system tumors.