白血病化疗患者并发口腔溃疡的护理观察(1)
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[摘要] 目的：探讨白血病化疗患者并发口腔溃疡的护理效果。方法：将90例患者随机分为观察组(n=45)和对照组(n=45)。对照组常规使用生理盐水行口腔护理，每日2次，实验组在此基础上每日使用复方利多卡因含漱液漱口6～8次，每次20 ml。比较两组的治疗效果。结果：观察组患者总有效率为88.89%，对照组总有效率为64.44%，两组比较差异有统计学意义(χ2=7.52，P<0.05)；观察组患者护理过程中出血发生率为20%，疼痛发生率为26.67%，与对照组比较，差异均有统计学意义(均P<0.05)。结论：复方利多卡因含漱液是白血病患者并发口腔溃疡的有效治疗护理方法，值得临床推广。
[关键词] 白血病；化疗；口腔溃疡；护理
[中图分类号] R557 [文献标识码] A [文章编号] 1673-7210(2011)12(b)-117-02
Nursing observation of leukemia chemotherapy patients with oral ulcers
MEI Junhui
The First Department of Hematology Specialty, the General Hospital of Chinese People's Liberation Army, Beijing 100853, China
[Abstract] Objective: To investigate the nursing care of leukemia chemotherapy patients with oral ulcers. Methods: 90 patients were randomly divided into observation group (n=45) and control group (n=45). Control group was taken normal saline oral care, 2 times a day, on this basis, the observation group was taken compound lidocaine gargle mouthwash 6-8 times，each 20 ml. The clinical efficacy of the two groups was compared. Results: The total effective rate of observation group was 88.89%, which of control group was 64.44%, the difference between the two groups was statistically significant (χ2=7.52, P<0.05); the care process incidence bleeding of patients in the observation group was 20%, the pain rate was 26.67%, compared with the control group, the differences were statistically significant (P<0.05). Conclusion: Compound lidocaine gargle is an effective treatment and care method for leukemia patients with oral ulcers, which is worthy of promotion.
[Key words] Leukemia; Chemotherapy; Oral ulcers; Care
白血病患者化疗期间及化疗后常常并发口腔炎、口腔溃疡，临床表现为口腔黏膜红肿、充血、糜烂、疼痛[1]。溃疡面常引发较为严重的疼痛，影响患者正常进食、饮水，导致低蛋白学者、水电解质紊乱，甚至出现全身性感染而致死亡等严重后果[2]。近年来，我科护理人员对白血病化疗并发口腔溃疡的患者进行正确评估、有效治疗、护理，取得良好的效果。现报道如下：
1 资料与方法
1.1 一般资料
选择2008年6月～2010年6月在我院住院的白血病化疗并发口腔溃疡患者90例，其中，男48例，女42例；年龄20～68岁，平均(40.32±12.87)岁；急粒白血病41例，急淋白血病25例，慢粒白血病14例，慢淋白血病10例；口腔溃疡面积0.1 cm×0.2 cm～0.9 cm×0.6 cm，平均0.84 cm×0.51 cm；溃疡数2～11处，平均8处；口腔溃疡程度：Ⅰ度27例，Ⅱ度45例，Ⅲ度10例，Ⅳ度8例。将患者随机分为观察组和对照组，每组45例，两组患者年龄、性别、溃疡数目、部位及程度等资料比较，差异无统计学意义(P>0.05)，具有可比性。
1.2 方法
对照组常规使用生理盐水行口腔护理，每日2次。每日观察口腔黏膜颜色、性质，溃疡面的大小、颜色以及出血情况等；做好清洁口腔目的、意义和重要性的解释工作；进食高蛋白、高热量、高维生素的半流质食物 ......
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