以质量求发展,以服务铸品牌

护理学报 ›› 2020, Vol. 27 ›› Issue (6): 23-28.doi: 10.16460/j.issn1008-9969.2020.06.023

• 循证护理 • 上一篇    下一篇

冷冻疗法降低化疗患者口腔黏膜炎发生的Meta分析

裴露斯, 杨雪梅, 翟田田, 赵亚芸, 冯兰棱, 张迁   

  1. 兰州大学护理学院,甘肃 兰州 730030
  • 收稿日期:2019-11-17 出版日期:2020-03-25 发布日期:2020-07-13
  • 通讯作者: 杨雪梅(1974-),女,甘肃兰州人,本科学历,副教授,主任护师,硕士研究生导师。
  • 作者简介:裴露斯(1996-),女,湖北钟祥人,本科学历,硕士研究生在读。
  • 基金资助:
    国家自然基金面上项目(81770525)

  • Received:2019-11-17 Online:2020-03-25 Published:2020-07-13

摘要: 目的 通过Meta分析评价冷冻疗法降低化疗患者口腔黏膜炎发生率的效果。方法 检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、The Cochrane Library、EMbase、Medline数据库,获取冷冻疗法作为干预措施对化疗患者口腔黏膜炎实施的随机对照试验,检索时限为建库至2019年6月,分别由2名研究人员独立根据纳排标准进行筛选文献,采用RevMan5.3软件进行Meta分析。结果 共纳入10篇随机对照试验,761例患者。Meta分析结果显示,与对照组相比,试验组冷冻疗法能有效地降低化疗引起的口腔黏膜炎发生率[RR=0.62,95%CI(0.53,0.72),P<0.01],减轻口腔黏膜炎严重程度[RR=0.37,95%CI(0.27,0.51),P<0.01],缓解疼痛以及减少止痛剂的使用[RR=0.13,95%CI(0.03,0.52),P<0.01]。在减少全肠外营养支持的需要上差异无统计学意义(P=0.23)。结论 冷冻疗法可以明显降低化疗引起的口腔黏膜炎发生率,减轻口腔黏膜炎严重程度,缓解疼痛以及减少止痛剂的使用,但在减少全肠外营养支持的需要方面缺乏证据支持,需要高质量的研究进行验证。

关键词: 冷冻, 化疗, 口腔黏膜炎, Meta分析

中图分类号: 

  • R473.73
[1] De Sanctis V, Bossi P, Sanguineti G, et al.Mucositis in Head and Neck Cancer Patients Treated with Radiotherapy and Systemic Therapies: Literature Review and Consensus Statements[J]. Crit Rev Oncol Hemat, 2016,100(4):147-166. DOI:10.1016/j.critrevonc.2016.01.010.
[2] Karagözoglu S, Filiz Ulusoy M.Chemotherapy: The Effect of Oral Cryotherapy on the Development of Mucositis[J]. J Clin Nurs, 2005,14(6):754-765. DOI:10.1111/j.1365-2702.2005.01128.x.
[3] Bhatt V, Vendrell N, Nau K, et al.Implementation of a Standardized Protocol for Prevention and Management of Oral Mucositis in Patients Undergoing Hematopoietic Cell Transplantation[J]. J Oncol Pharm Pract,2010,16(11):195-204. DOI:10.1177/1078155209348721.
[4] Vokurka S, Chvojkova I, Svoboda T, et al.The Impact of Oral Cryotherapy and Oral and Gastrointestinal Mucositis after Autologous Stem Cell Transplantation[J]. Eur J Oncol Nurs, 2014, 18(2):228-229. DOI:10.1016/j.ejon.2013.11.001.
[5] Katranc1 N, Ovayolu N, Ovayolu O, et al. Evaluation of the Effect of Cryotherapy in Preventing Oral Mucositis Associated with Chemotherapy-a Randomized Controlled Trial[J]. Eur J Oncol Nurs, 2012, 16(4):339-344. DOI:10.1016/j.ejon.2011.07.008.
[6] Batlle M, Morgades M, Vives S, et al.Usefulness and Safety of Oral Cryotherapy in the Prevention of Oral Mucositis after Conditioning Regimens with High-dose Melphalan for Autologous Stem Cell Transplantation for Lymphoma and Myeloma[J]. Eur J Haematol, 2014, 93(6):487-491. DOI:10.1111/ejh.12386.
[7] Sato A, Saisho-Hattori T, Koizumi Y, et al.Prophylaxis of Mucosal Toxicity By Oral Propantheline and Cryotherapy in Children with Malignancies Undergoing Myeloablative Chemo-radiotherapy[J]. Tohoku J Exp Med, 2006, 210(4):315-320. DOI:10.1620/tjem.210.315.
[8] Ohbayashi Y, Imataki O, Ohnishi H, et al.Multivariate Analysis of Factors Influencing Oral Mucositis in Allogeneic Hematopoietic Stem Cell Transplantation[J]. Ann Hematol, 2008, 87(10):837-845. DOI:10.1007/s00277-008-0508-6.
[9] Mori T, Aisa Y, Yamazaki R, et al.Cryotherapy for the Prevention of High-dose Melphalan-induced Oral Mucositis[J]. Bone Marrow Transpl, 2006, 38(9):637-638. DOI:10.1038/sj.bmt.1705494.
[10] Dumontet C, Sonnet A, Bastion Y, et al.Prevention of High Dose L-PAM-induced Mucositis by Cryotherapy[J]. Bone Marrow Transplant,1994,14(3):492-494. DOI:10.1007/BF02303818.
[11] Aisa Y, Mori T, Kudo M, et al.Oral Cryotherapy for the Prevention of High-dose Melphalan-induced Stomatitis in Allogeneic Hematopoietic Stem Cell Transplant Recipients[J]. Support Care Cancer, 2005, 13(4):266-269. DOI:10.1007/s00520-004-0726-y.
[12] Baydar M, Dikilitas M, Sevinc A, et al.Prevention of Oral Mucositis Due to 5-Fluorouracil Treatment with Oral Cryotherapy[J]. J Natl Med Assoc, 2005, 97(8):1161-1164. DOI:10.1002/ijc.26320.
[13] Worthington HV, Clarkson JE, Bryan G, et al. Interventions for Preventing Oral Mucositis for Patients with Cancer Receiving Treatment[J]. Cochrane Db Syst Rev,2011(4):CD000978. DOI:10.1002/14651858.
[14] Kanuga S.Cryotherapy and Keratinocyte Growth Factor May be Beneficial in Preventing Oral Mucositis in Patients with Cancer, and Sucralfate is Effective in Reducing its Severity[J]. J Am Dent Assoc, 2013, 144(8):928-929. DOI:10.14219/jada.archive.2013.0211.
[15] Wang L, Gu Z, Zhai R, et al.Efficacy of Oral Cryotherapy on Oral Mucositis Prevention in Patients with Hematological Malignancies Undergoing Hematopoietic Stem Cell Transplantation: A Meta-analysis of Randomized Controlled Trials[J]. PLoS One, 2015, 10(5):e0128763. DOI:10.1371/journal.pone.0128763.
[16] Higgins JP, Green S.Cochrane Handbook for Systematic Reviews of Interventions,Version 5.1.0[M]. London:Wiley-Blackwell,2011:102-108.
[17] 胡雁. 循证护理学[M].北京:人民卫生出版社,2012:573-575.
[18] Salvador P, Azusano C, Wang L, et al.A Pilot Randomized Controlled Trial of an Oral Care Intervention to Reduce Mucositis Severity in Stem Cell Transplant Patients[J]. J Pain Symptom Manag, 2012, 44(1):64-73. DOI:10.1016/j.jpainsymman.2011.08.012.
[19] Lilleby K, Garcia P, Gooley T, et al.A Prospective, Randomized Study of Cryotherapy During Administration of High-dose Melphalan to Decrease the Severity and Duration of Oral Mucositis in Patients with Multiple Myeloma Undergoing Autologous Peripheral Blood Stem Cell Transplantation[J].Bone Marrow Transpl,2006,37(11):1031-1035. DOI:10.1038/sj.bmt.1705384.
[20] Marchesi F, Tendas A, Giannarelli D, et al.Cryotherapy Reduces Oral Mucositis and Febrile Episodes in Myeloma Patients Treated with High-dose Melphalan and Autologous Stem Cell Transplant: A Prospective, Randomized Study[J]. Bone Marrow Transpl, 2017, 52(1):154-156. DOI:10.1038/bmt.2016.207.
[21] Sorensen JB, Skovsgaard T, Bork E, et al.Double-blind, Placebo-controlled, Randomized Study of Chlorhexidine Prophylaxis for 5-Fluorouracil-based Chemotherapy-induced Oral Mucositis with Nonblinded Randomized Comparison to Oral Cooling (Cryotherapy) in Gastrointestinal Malignancies[J]. Cancer, 2008, 112(7):1600-1606. DOI:10.1002/cncr.23328.
[22] Katranci N, Ovayolu N, Ovayolu O, et al.Evaluation of the Effect of Cryotherapy in Preventing Oral Mucositis Associated with Chemotherapy-A Randomized Controlled Trial[J]. Eur J Oncol Nurs, 2012, 16(4):339-344. DOI:10.1016/j.ejon.2011.07.008.
[23] Mahood DJ, Dose AM, Loprinzi CL, et al.Inhibition of Fluorouracil-induced Stomatitis by Oral Cryotherapy[J]. J Clin Oncol, 1991, 9(3):449-452. DOI:10.1200/JCO.1991.9.3.499.
[24] Cascinu S, Fedeli A, Fedeli S L, et al.Oral Cooling (Cryotherapy), an Effective Treatment for the Prevention of 5-Fluorouracil-induced Stomatitis[J]. Eur J Cancer B Oral Oncol, 1994, 30(4):234-236. DOI:10.1016/0964-1955(94)90003-5.
[25] Svanberg A, Öhrn K, Birgegård G.Oral Cryotherapy Reduces Mucositis and Improves Nutrition-A Randomised Controlled Trial[J]. J Clin Nurs, 2010, 19(15-16):2146-2151. DOI:10.1111/j.1365-2702.2010.03255.x.
[26] Papadeas E, Naxakis S, Riga M, et al.Prevention of 5-Fluorouracil-related Stomatitis by Oral Cryotherapy: A Randomized Controlled Study[J]. Eur J Oncol Nurs, 2007, 11(1):60-65. DOI:10.1016/j.ejon.2006.05.002.
[27] Idayu RMN, Lei PC, Wan WZI, et al.Oral Cryotherapy: Prevention of Oral Mucositis and Pain Among Patients with Colorectal Cancer Undergoing Chemotherapy[J]. Clin J Oncol Nurs, 2018, 22(5):555-560.DOI:10.1188/18.CJON.555-560.
[28] Askarifar M, Lakdizaji S, Ramzi M, et al.The Effects of Oral Cryotherapy on Chemotherapy-induced Oral Mucositis in Patients Undergoing Autologous Transplantation of Blood Stem Cells: A Clinical Trial[J]. Iran Red Crescent Me, 2016, 18(4):e24775. DOI:10.5812/ircmj.24775.
[29] Shin N, Kang Y.The Effects of Oral Cryotherapy on Oral Mucositis, Reactive Oxygen Series, Inflammatory Cytokines, and Oral Comfort in Gynecologic Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial[J]. J Korean Acad Nurs, 2019,49(2):149-160.DOI:10.4040/jkan.2019.49.2.149.
[30] Heydari A, Sharifi H, Salek R.Effect of Oral Cryotherapy on Combination Chemotherapy-induced Oral Mucositis: A Randomized Clinical Trial[J]. Middle East J Cancer, 2012, 3(2-3):55-64.
[31] 赵凤军,王银萍,赵秀荣,等.生理盐水漱口预防急性白血病化疗后真菌性口腔炎的研究[J].护理研究, 2005,19(11B):2370-2371. DOI:10.3969/j.issn.1009-6493.2005.26.010.
[32] 周琳琳,苏少晨,翟田田,等.蜂蜜预防放化疗导致的口腔黏膜炎及相关疼痛的系统评价[J].中国护理管理,2019,19(5):693-700.DOI:10.3969/j.issn.1672-1756.2019.05.011.
[33] Peterson DE, Öhrn K, Bowen J, et al.Systematic Review of Oral Cryotherapy for Management of Oral Mucositis Caused by Cancer Therapy[J]. Support Care Cancer, 2013, 21(1):327-332. DOI:10.1007/s00520-012-1562-0.
[34] 王悦,付菊芳,白燕妮,等.癌症患者对化疗导致周围神经病变症状体验及应对方式的质性研究[J].护理学报,2016,23(22):9-13. DOI:10.16460/j.issn1008-9969.2016.22.009.
[35] 赵炳媛,刘凤,姜桂春,等.肿瘤患者阿片类药物相关性便秘严重程度现状及影响因素分析[J].护理学报,2019,26(11):9-14. DOI:10.16460/j.issn1008-9969.2019.11.009.
[1] 朱一凡, 陈芷谦, 郭巧红, 苏娅丽. 196例乳腺癌化疗患者尊严现状及影响因素分析[J]. 护理学报, 2020, 27(12): 33-37.
[2] 刘敏, 刘安诺, 吴德全, 高宇, 陈国红, 朱桂月, 张萌, 马雯, 丁翠路. 运动干预对2型糖尿病老年患者步行功能影响的Meta分析[J]. 护理学报, 2020, 27(11): 40-45.
[3] 伊静, 董建俐, 程洋, 沙丽艳. 200例肝癌首次经动脉化疗栓塞术后患者心理痛苦现状及影响因素分析[J]. 护理学报, 2020, 27(11): 61-65.
[4] 孙烯辉, 杨丽, 黄德斌, 张桂宁, 李琳, 廖婷婷, 邱丽燕, 巫雪花. 机械通气患者胸部物理治疗效果的Meta分析[J]. 护理学报, 2019, 26(17): 31-36.
[5] 秦秀丽, 周俊芳, 付茜, 赵馨, 周婷, 孙巧云. 儿童化疗性口腔黏膜炎测评工具的研究进展[J]. 护理学报, 2019, 26(16): 43-45.
[6] 邓波, 江波, 陈静文, 李显蓉. 自体富血小板纤维蛋白治疗慢性伤口有效性与安全性的Meta分析[J]. 护理学报, 2019, 26(13): 6-11.
[7] 张红梅, 傅荣, 张宁. 正念疗法对糖尿病患者糖尿病相关心理痛苦影响的Meta分析[J]. 护理学报, 2019, 26(13): 44-49.
[8] 田婷, 黄锐娜, 戚熠, 周亚娟, 韩慧, 刘婉君, 贺海霞, 吴小婉. 肿瘤患者PICC置管相关静脉血栓形成危险因素Meta分析[J]. 护理学报, 2019, 26(11): 49-54.
[9] 陈冰,仲冬梅. 132例经肝动脉栓塞化疗肝癌中晚期患者自我效能现状调查[J]. 护理学报, 2018, 25(9): 48-50.
[10] 吴婷,侯云霞,阎玲. 肿瘤化疗患者味觉改变评估及干预研究进展[J]. 护理学报, 2018, 25(4): 32-36.
[11] 彭青,李雪,张雪,苏建萍. 112例宫颈癌术后化疗期患者创伤后成长水平及影响因素分析[J]. 护理学报, 2018, 25(3): 5-10.
[12] 黄旭霞, 曾秀娟, 彭丽娟, 张璋. 淋巴瘤初治化疗患者拒绝PICC置管的原因分析[J]. 护理学报, 2018, 25(23): 40-42.
[13] 李真, 曹晶, 李佳倩, 吴欣娟. 卒中后谵妄危险因素的Meta分析[J]. 护理学报, 2018, 25(22): 38-43.
[14] 冷志兵, 杨晓玲, 杨平, 汪晓媛, 谢建雷, 蒲亨萍. 院前与入院后气管插管对重型颅脑损伤患者 预后影响的Meta分析[J]. 护理学报, 2018, 25(20): 18-23.
[15] 刘瑞红,朱松,万晶晶,刘映红. 加温输液对预防产妇剖宫产术后低体温和寒颤有效性的Meta分析[J]. 护理学报, 2018, 25(2): 41-47.
Viewed
Full text


Abstract

Cited

  Shared   
[1] 赵迪, 赵梦璐, 王娜, 付明晶, 梁凤, 张伟, 王爱敏. 青岛市592名社区老年人社会隔离现状及影响因素研究[J]. 护理学报, 2020, 27(11): 6 -10 .
[2] 高莹, 吴玉娥, 张建荣, 崔鑫浩, 陈淑玲, 叶丽芳, 杜秀珍. 基于循证构建轻症急性胰腺炎患者早期经口进食时机评估及管理方案[J]. 护理学报, 2020, 27(11): 11 -15 .
[3] 谢延真, 李壮苗, 张佳宇, 纪秋露, 吴宇欣. 灸法治疗脑卒中后偏瘫的文献计量学分析[J]. 护理学报, 2020, 27(11): 16 -20 .
[4] 练巧兰, 欧阳红莲. 成人ICU患者探视管理研究进展[J]. 护理学报, 2020, 27(11): 21 -25 .
[5] 叶冬婷, 张沁莲, 景霜, 郭佳, 邢雁芬. 家属对ICU患者转出体验的Meta整合[J]. 护理学报, 2020, 27(11): 33 -39 .
[6] 郭晓宇, 史冬立, 张振美, 李娜, 张佩凤, 杨丽娟. 全麻腰椎术后男性患者早期拔除尿管的最佳证据总结[J]. 护理学报, 2020, 27(11): 46 -51 .
[7] 吴静, 姚惠萍, 何巧, 蒋美娜, 郎毅平, 刘仁洋. 成人重症患者血糖管理相关临床实践指南的质量评价[J]. 护理学报, 2020, 27(11): 52 -56 .
[8] 李秋萍, 韩斌如, 陈曦. 外科大手术老年患者发生术后低蛋白血症影响因素的队列研究[J]. 护理学报, 2020, 27(11): 66 -70 .
[9] 李细珍, 曹美嫦, 邓菊英, 曾满萍, 欧利芳. 叙事疗法对鼻咽癌患者癌症复发恐惧与希望水平的影响[J]. 护理学报, 2020, 27(11): 71 -74 .
[10] 徐丽芬, 杨荆艳, 颜巧元, 曾俊, 张燕. 永久性尿路造口患者应用视频版思维导图健康教育的效果观察[J]. 护理学报, 2020, 27(11): 75 -78 .