配制漱口液对肝脏恶性肿瘤患者靶向治疗引起的口腔黏膜炎的疗效分析

肝癌电子杂志 ›› 2023, Vol. 10 ›› Issue (2): 51-54.

配制漱口液对肝脏恶性肿瘤患者靶向治疗引起的口腔黏膜炎的疗效分析

吴舒¹, 刘艳¹, 占正寅¹, 李晓青¹,刘姿荣¹, 黄丽惠², 李彩云³, 王静雅³, 路虹^4,*

1.国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院肝胆外科,广东深圳 518116;
2.国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院重症监护病房,广东深圳 518116;
3.国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院肝胆外科,北京 100021;
4.国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院护理部,广东深圳 518116

收稿日期:2022-10-08 出版日期:2023-06-30 发布日期:2023-08-14
通讯作者: ^*路虹,E-mail：luhong862525@sina.com
作者简介:吴舒,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院,肝胆外科
基金资助:
深圳市医疗卫生“三名工程”项目（SZSM202011010）

Analysis of the effect of mouthwash prepared with mannitol on tyrosine kinase receptor inhibitor oral mucosal adverse reactions in patients with liver cancer

Wu Shu¹, Liu Yan¹, Zhan Zhengyin¹, Li Xiaoqing¹, Liu Zirong¹, Huang Lihui², Li Caiyun³, Wang Jingya³, Lu Hong^4,*

1. Department of Hepatobiliary Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China;
2. Intensive Care Unit, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China;
3. Department of Hepatobiliary Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;
4. Department of Nursing, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China

Received:2022-10-08 Online:2023-06-30 Published:2023-08-14

摘要/Abstract

摘要： 目的: 探讨甘露醇、利多卡因、地塞米松配制漱口液对肝脏恶性肿瘤患者靶向治疗中引起的口腔黏膜炎的疗效。
方法：选择2019年8月至2021年3月中国医学科学院北京协和医学院肿瘤医院深圳医院收治的因肝脏恶性肿瘤且接受索拉非尼、仑伐替尼等分子靶向药治疗出现口腔黏膜炎的46例患者,按照随机数字表法分为研究组和对照组各23例。研究组患者应用甘露醇、利多卡因、地塞米松配制漱口液进行干预,对照组患者应用口腔黏膜炎常规护理干预。记录并比较两组患者应用配制漱口液3d和7d的数字分级评分法（numerical rating scale,NRS）评分,以及两组患者恢复普通饮食的时间。
结果：应用配制漱口水当日、3d两组患者NRS评分差异均无统计学意义[（3.13±0.69）分比（3.61±0.33）分,t=-1.133,P=0.108;（1.35±0.71）分比（1.61±1.03）分,t=-0.996,P=0.074];应用配制漱口水7d研究组患者NRS评分低于对照组患者[0（0,0.50）分比（0.70±0.63）分],且差异有统计学意义（z=-2.584,P<0.015）。应用配制漱口水后,研究组患者恢复普通饮食的时间为（1.65±1.11）d,短于对照组患者恢复普通饮食的时间（3.00±0.52）d,且差异有统计学意义（t=5.26,P=0.001）。
结论：甘露醇、利多卡因、地塞米松配制漱口液应用于分子靶向药引起的口腔黏膜炎效果良好。

关键词: 肝脏恶性肿瘤, 口腔黏膜炎, 靶向治疗, 配制漱口液

Abstract: Objective: Tyrosine kinase transmembrane receptor inhibitors are widely used in the clinical treatment of liver cancer, and oral mucosal adverse reactions may occur. This study is to explore the effect of mannitol, lidocaine, dexamethasone and mouthwash in such patients.
Method: In this paper, 46 patients with liver cancer who were treated with sorafenib, lenvatinib, regorafenib or cetuximab were selected as the research objects (all oral mask reactions were grade 2-3). They were randomly divided into 23 cases in the observation group and 23 cases in the control group. The control group used mannitol, lidocaine and dexamethasone to rinse the mouth when adverse reactions to the oral mask occurred, and the observation group was.
Result: The effect of oral mucosal adverse reactions in the observation group was later than that in the control group and the symptoms were milder. The difference between the two groups was significant (P<0.05).
Conclusion: The mannitol, lidocaine and dexamethasone preparation has a good effect on the oral mucosal side effects of the tyrosine kinase transmembrane receptor inhibitor, and it is worthy of clinical application. This article provides references for oncology nursing workers to deal with related adverse reactions.

Key words: Liver cancer, Oral mucositis, Targeted therapy, Mouthwash

吴舒, 刘艳, 占正寅, 李晓青,刘姿荣, 黄丽惠, 李彩云, 王静雅, 路虹. 配制漱口液对肝脏恶性肿瘤患者靶向治疗引起的口腔黏膜炎的疗效分析[J]. 肝癌电子杂志, 2023, 10(2): 51-54.

Wu Shu, Liu Yan, Zhan Zhengyin, Li Xiaoqing, Liu Zirong, Huang Lihui, Li Caiyun, Wang Jingya, Lu Hong. Analysis of the effect of mouthwash prepared with mannitol on tyrosine kinase receptor inhibitor oral mucosal adverse reactions in patients with liver cancer[J]. Electronic Journal of Liver Tumor, 2023, 10(2): 51-54.

参考文献

[1] MOEINI A, SIA D, ZHANG Z, et al.Mixed hepatocellular cholangiocarcinoma tumors: Cholangiolocellular carcinoma is a distinct molecular entity[J]. J Hepatol, 2017, 66(5): 952-961.
[2] 赵宏, 蔡建强. 原发性肝癌非手术治疗的现状与展望[J]. 中华肝胆外科杂志, 2011, 17(7): 527-530.
[3] LANG D S.Interventions for preventing oral mucositis for patients with cancer receiving treatment[J]. Clin J Oncol Nurs, 2013, 17(3): 340.
[4] EILERS J, MILLION R.Prevention and management of oral mucositis in patients with cancer[J]. Semin Oncol Nurs, 2007, 23(3): 201-212.
[5] BRUIX J, QIN S, MERLE P, et al.Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet, 2017, 389(10064): 56-66.
[6] FREITES-MARTINEZ A, SANTANA N, ARIAS-SANTIAGO S, et al.Using the Common Terminology Criteria for Adverse Events (CTCAE - Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies. Actas Dermosifiliogr (Engl Ed), 2021, 112(1): 90-92.
[7] 中国抗癌协会肿瘤护理专业委员会. 中国癌症症状管理实践指南——口腔黏膜炎[J]. 护士进修杂志, 2020, 35(20): 1871-1878.
[8] WANG Y, HE F, ZHANG H, et al.Preparation and identification of an anti-idiotypic antibody antagonist (FG8) for EGFR that shows potential activity against liver cancer cells[J]. Biotechnol Letters, 2021, 43(2): 369-382.
[9] KANAGALINGAM J, WAHID M I A, LIN J C, et al. Patient and oncologist perceptions regarding symptoms and impact on quality-of-life of oral mucositis in cancer treatment: results from the Awareness Drives Oral Mucositis PercepTion (ADOPT) study[J]. Support Care Cancer, 2018, 26(7): 2191-2200.
[10] LALLA R V, BOWEN J, BARASCH A, et al.Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy[J]. Cancer, 2014, 120(10): 1453-1461.
[11] ROTHSCHILD S I, BETTICHER D, ZENHÄUSERN R, et al. Prospective, observational practice survey of applied skin care and management of cetuximab-related skin reactions: PROSKIN study[J]. Cancer Chemother Pharmacol, 2019, 84(4): 881-889.
[12] 程红霞, 罗彦, 程红玉. 口腔冷疗法预防放疗联合化疗移植预处理患者口腔黏膜炎11例疗效观察[J].临床医药实践, 2017, 26(8): 613-616.
[13] 邱志锋, 吴苗, 邱爱钗. 蜂胶防治乳腺癌化疗致口腔黏膜炎的疗效评价[J]. 循证护理, 2021, 7(13): 1825-1828.
[14] HILL A, KISS N, HODGSON B, et al.Associations between nutritional status,weight loss,radiotherapy treatment toxicity and treatment outcomes in gastrointestinal cancer patients[J]. Clin Nutr, 2011, 30(1): 92-98.
[15] PHIPPEN N T, LOWERY W J, BARNETT J C, et al.Evaluation of the Patient Generated Subjective Global Assessment (PG-SGA) as a predictor of febrile neutropenia in gynecologic cancer patients receiving combination chemotherapy: a pilot study[J]. Gynecol Oncol, 2011, 123(2): 360-364.