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    題名: 蜂膠口腔護理方案於化學治療肺癌患者口腔黏膜炎之預防成效
    作者: 唐凱琳
    貢獻者: 護理學研究所
    關鍵詞: 蜂膠;口腔炎;口腔護理專案;化學治療;肺癌
    日期: 2010
    上傳時間: 2010-10-21 09:37:31 (UTC+8)
    摘要: 口腔黏膜是腸胃系統的第一道防線,也是攝取食物及液體的必經通道,破損的黏膜會成為致病菌感染入口,接受化學治療患者有35~40%發生口腔黏膜炎,而肺癌所使用的化療藥物部份藥物更會分泌至唾液中,直接造成口腔毒性。口腔炎的發生會影響疾病死亡率,生活品質,甚而延誤化學治療進行。臨床上常可見到病患使用蜂膠預防口腔炎,但缺乏實證護理依據本研究即探討蜂膠口腔護理方案於肺癌病患接受化學治療期間預防口腔炎之成效。
    本研究採實驗性研究設計將個案分為實驗組與對照組,實驗組為接受蜂膠漱口之口腔護理措施,對照組為接受蒸餾水漱口之口腔護理措施口腔護理方案是根據PRO-SELF©:Mouth Aware(PSMA(Larson et al.,1998)來實行。
    研究結果顯示發生WHO嚴重三級口腔黏膜炎、鵝口瘡發生兩組前後測分數無差異;口腔功能項目「聲音」、「吞嚥」分數無顯著差異,在其它功能項目:「嘴唇」、「舌頭」、「唾液腺」、「黏膜」、OAG總分蜂膠組皆顯著低於蒸餾水組,而牙菌斑指數兩組在介入措施後都呈現下降情形。整體而言蜂膠可以降低肺癌化學治療期間黏膜炎的發生,配合完整的潔牙專案兩組皆可達成有效降低牙菌斑指數。在漱口水選擇上蜂膠漱口預防黏膜炎成效優於蒸餾水。

    The purpose of this experimental design study was to determine the efficacy of two different oral care protocols in the prophylaxis of mucositis in Non-small cell lung cancer patients with receiving chemotherapy.61 patients were randomly assigned to a treatment or control group .All patient received standard protocol of oral care differed in the type of rinse solution.The treatment group used 0.8 % propolis .The control group rinsed with disteal water.
    The World Healthy Organization mucositis grading system and oral assessment guide were used to assess oral status every day during hospitalization and 7~10 days after chemotherapy.A statistically difference was not found between WHO scales、oral candidiasis. and Oral Assessment Guide 「voice」「Swallow」category .However the mucositis severity score,Oral Assessment Guide score and functional indicator 「lips」「tongue」「saliva」were significant lower(P < .05) .Plaque reduce through oral care protocol in both groups .
    The propolis seemed to be superior to disteal water for preventing chemotherapy–induced oral mucositis .
    關聯: 85頁
    描述: (一)論文目次
    目錄
    致謝 ………………………………………………………Ⅰ
    中文摘要 ………………………………………………………Ⅱ
    英文摘要 ………………………………………………………Ⅵ
    目錄 ………………………………………………………Ⅳ
    圖表目次 ……………………………………………………Ⅸ
    第一章 緒論
    第一節 研究動機與重要性 ………………………………… 1
    第二節 研究假設……………………………………………… 2
    第二章 文獻查證
    第一節 化學治療與口腔炎 …….…………………………… 3
    第二節 口腔炎的評估與與處理 ……………………………5
    第三節 蜂膠於口腔粘膜的作用及角色………………………6
    第四節 名詞解釋………………………………………………8
    第五節 研究架構與假設 ……………………………………16
    第三章 研究方法
    第一節 研究設計……………………………………………17
    第二節 研究場所與研究對象………………………………18
    第三節 介入措施……………………………………………19
    第四節 研究工具……………………………………………21
    第五節 信效度檢定…………………………………………22
    第六節 資料收集過程………………………………………24
    第七節 倫理考量……………………………………………25
    第八節 資料分析……………………………………………26
    第四章 研究結果
    第一節 研究對象基本人口學與疾病、治療屬性分析……. 27
    第二節 不同口腔護理方案對口腔黏膜之影響……………..34
    第三節 不同口腔護理方案對口腔功能狀態之影響………..45
    第四節 不同口腔護理方案對牙菌斑指數之影響 …………..60
    第五節 不同口腔護理方案對口腔黴菌感染狀態之影響……64
    第五章 討論
    第一節 病患特性………………………………………………66
    第二節 不同口腔方案對口腔黏膜狀態之影響……………… 67
    第三節 不同口腔方案對口腔功能狀態之影響…………….…67
    第四節 不同口腔方案對牙菌斑狀態之影響……………….…68
    第五節 不同口腔方案對發生口腔黴菌感染(鵝口瘡)狀態之
    影響…………………………………………………… 69
    第六章 結論、限制與建議
    第一節 結論……………………………………………………70
    第二節 研究限制與建議…………………………………........71
    第三節 護理運用 ………………………………..…. 72
    參考文獻
    中文文獻 …………………………………………………..73
    英文文獻 …………………………………………………74
    附件 …………………………………………………… 78

    (二)參考文獻
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    顯示於類別:[學士後護理學系] 博碩士論文

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