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題名:頭頸部放射線療法之癌症病人施行口腔護理方案成效之探討
書刊名:長庚護理
作者:楊翠雲高紀惠馬素華 引用關係賴允亮 引用關係陳君侃
作者(外文):Yang, T. Y.Kao, C. H.Maa, S. H.Lai, Y. L.Chen, J. K.
出版日期:1996
卷期:7:3=15
頁次:頁15-29
主題關鍵詞:頭頸部放射線療法口腔粘膜改變口腔護理方案Head and neck radiotherapyAlteration in oral mucous membraneOral care protocol
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(5) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:5
  • 共同引用共同引用:0
  • 點閱點閱:31
     口腔黏膜改變是接受頸部放射線療法病人最常見的問題,其發生率高達50%∼78%。病人常因治療後口腔粘膜發炎、潰瘍、口乾、吞嚥及咀嚼疼痛、味覺改變、及體重下降等症狀發生,嚴重影響治療期間的生活品質。護理人員若能於治療期間實施病人一套完整有效的口腔護理方案,將可改善病人口腔不適的情形發生。 本研究目的即探討施行口腔護理方案,對接受頭頸部放射線療法病人口腔粘膜構造、口腔功能、白血球計數、及體重改變的影響。 本研究採準實驗設計法依治療先後順序選取50位接受頭頸部放射線療法之癌症病人,分派實驗組和對照組各25人。當兩組病人之「口腔粘膜改變評量表」達14分時,實驗組提供衛教手冊並教導每日執行口腔護理方案;而對照組只接受常規護理衛教。於放射線治療期間每週評估兩組病人之口腔粘膜構造、口腔功能;以及治療前及每隔一週 各評估白血球計數及體重改變情形。 研究結果顯示,執行口腔護理方案後。 (一)實驗組病人的口腔粘膜構造改變程度較對照組小。 (二)實驗組病人的口腔功能,除味覺無顯著改善外,其他項目如:唾液分泌、吞嚥、咀嚼、及說話等改變程度較對照組為小。 (三)兩組病人在白血球計數的改變程度未達顯著差異。(四)實驗組病人體重改變較對照組為小。 由此可見,口腔護理方案的實施,能有效減輕放射線治療病人的口腔粘膜構造、口腔功能、及體重改變的程度,故可提供臨床護理人員一套明確的護理指引。
     The alteration in oral membrane of cancer patients is a common health problem which caused by head and neck. radiotherapy. Approximately 50~78% patients demonstrated the symptoms of: mycosis’s, oral ulcer, xerostoma, painful of swell-owing and chewing, taste change, and body weight loss. These symptoms extremely affect their quality of life. The comprehensive and effective oral care protocol needs to be implemented to prevent or relieve the oral discomfort. The purpose of this Study were to explore the effects of oral care protocol on oral membrane structure, oral function, WBC and body weight of cancer patients undergone head and neck radiotherapy. A quasi experiment study was designed and 50 head and neck cancer patients were consecultively assigned to experimental group (n=25) and control group (n=25). The oral care protocol was demonstrated and implemented on experimental group when the oral score was more than 14. Each experimental patient practiced oral care protocol daily at home. The control group received routine care. The oral membrane structure and oral function were assessed weekly and WBC and body weight were measured every other week during the radiotherapy. The results showed as follows: (1) Experimental group presented lower altercation in oral mucous structure then control group. (2) Experimental group demonstrated lower altercation in oral function then control group. (3) There was no significant difference in WBC change between two groups. (4) Experimental group had lower body weight change than control group. The results of this study suggested that the oral care protocol can be an effective nursing intervention in clinical setting.
期刊論文
1.Lockhart, P.、Clark, S.(1994)。Pretherapy dental status of patients with malignant conditions of the head and neck。Oral Surgery, Oral Medicine, Oral Pathology,77,236-247。  new window
2.Kenny, S. A.(1990)。Effect of two oral care protocols on the incidence of stomatitis in hematology patients。Cancer Nursing,13(6),345-353。  new window
3.Dudjak, L. A.(1987)。Mouth care for mucositis due to radiation therapy。Cancer Nursing,10(3),131-140。  new window
4.Franzen, L.、Henrisksson, R.、Littbran, B.(1995)。Effects of sucralfate on mucositis during and following radiotherapy of malignancies in the head and neck region。Acta Oncologica,34(2),219-223。  new window
5.Foot, R. L.、Loprinzi, C. L.、Frank, A. R.、Gulavita, S.、Tewfill, H. H.(1994)。Randomized trial of a chlorexide mouthwash for alleviation of radiation induce d mucositis。Journal of Clinical Oncology,12(12),2630-2633。  new window
6.Jansma, J.、Vissink, A.、Bouma, J.、Vermey, A.、Panders, A. K.(1992)。A survey of prevention and treatment regimens for oral sequelae resulting from head and neck radiotherapy used in dutch radiotherapy institutes。Journal Radiat-ion Oncology Biology Physical,24,359-367。  new window
7.Janja, N. A.、Weissma, M. D.、Pahule. A.(1992)。Improved pain management with daily nursing intervention during radiation therapy for head and neck carcinoma。Journal Radiation Oncology Biology Physical,23,647-652。  new window
8.Johnannes, H. A.、Willem, A. J.(1992)。Accelerated fractionation radiotherapy for laryngeal cancer, acute and late toxicity。International Journal Radiation Oncology Biology Physical,24,497-503。  new window
9.Maciejewsk, B.、Zajusz, A.、Pilecki, B.、Dileck, J.(1991)。Acute mucositis in the stimulated oral mucosa of patients during radiotherapy for head and neek cancer。Radiotherapy and Oncology,22,7-11。  new window
10.Rugg, T.、Dishe, S.、Saunder, M. I.(1990)。Smoking and mucosal reactions to radiotherapy。The British Journal of Radiology,63,554-556。  new window
11.Shay, K.(1994)。Identifying the needs of the early dental patient。Dental Clinics of North America,38(3),499-521。  new window
12.Shara, K. A.、Ghareeb, M. A.、Zaher, S.(1993)。Radiotherapeutic effect on oropharyngeal flora in patients with head and neck。The Journal of Laryngology and Otology,107,222-227。  new window
13.Whittet, H. B.、Brockbank, M.、Feyerabend, C.、Lund, V. J.(1991)。Serum cotinine as an objective marker for smoking habit in head and neck malignancy。The Journal of Laryngology and Otology,105,1036-1039。  new window
14.黃貴薰、戴玉慈、黃淑珍(19871200)。鼻咽癌病人放射線治療期間身體副作用之探討。中華民國癌症醫學會雜誌,3(4),7-17。  延伸查詢new window
研究報告
1.行政院衛生署(1994)。台海地區人口統計。行政院衛生署。  延伸查詢new window
圖書
1.王道(1992)。口腔解剖學。臺北:合記圖書出版社。  延伸查詢new window
2.劉幕台、何瑞明(1984)。放射腫瘤治療計劃與劑量學。台北:南山堂。  延伸查詢new window
3.關學婉(1989)。口腔病理學。台北:環球。  延伸查詢new window
4.Bente, G. C.、Nelson, C. E.、Noel, K.(1989)。Treatment Planning & Dose Calculation in Radiation Oncology。Pergamon Press。  new window
5.Wan, C. C.(1990)。Radiation Therapy for Head and Neck Neoplasms: Techniques and Results。Year Book Medical Publishers。  new window
圖書論文
1.Hall, E. J.(1994)。Radiobiology for the Radiologist。Principles of Radiation Oncology and Cancer Radiotherapy。J.B. Lippincott Co.。  new window
2.Thoma, A. C.(1993)。Handling of Radiation Accident Patients by Paramedical and Hospital Personnel。Radioation Injuries。CRC Press。  new window
 
 
 
 
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