林云月 林朝春 鲁相园

【摘要】 目的：通过全员参与品管圈活动，制定乳腺癌化疗患者口腔护理标准流程，降低口腔炎的发生率。方法：选取2018年10月-2019年4月，在某三甲医院接受化疗的乳腺癌患者100例，平均年龄（47.23±6.77）岁（29～68岁）。所有患者随机分为两组，每组50例，一组为试验组，接受品管圈活动指导下的口腔护理;一组为对照组，接受一般口腔护理。记录两组患者经护理后口腔炎的发生率及严重程度，口腔炎发生率和严重程度的比较分别采用字2检验和Mann-Whitney秩和检验。结果：试验组口腔炎发病率为32%，而对照组为74%，两组差异有统计学意义（字2=6.83，P=0.001）。两组所有口腔炎病例均为OAGⅡ级（轻至中度口腔炎），试验组严重程度较对照组更低，且等级严重程度比较有显著性差异（Z=-4.186，P=0.00）。结论：品管圈活动大大降低了乳腺癌化疗患者口腔炎的发生率，可以推广应用于乳腺癌化疗后口腔护理。

【关键词】 品管圈活动 乳腺癌 化疗 口腔炎 口腔评估量表

doi：10.14033/j.cnki.cfmr.2019.29.045 文献标识码 B 文章编号 1674-6805（2019）29-0-03

[Abstract] Objective： Through the participation of all members in the quality control circle （QCC）activities， to establish the standard process of oral care for breast cancer chemotherapy patients to reduce the incidence of stomatitis. Method： From October 2018 to April 2019， 100 breast cancer patients [29-68 years old， averaged （47.23±6.77） years old] who underwent chemotherapy in our department were selected in this study. All patients were randomly divided into two groups， and 50 in each group. One group was the experimental group， receiving oral care under the guidance of the QCC activity; the other group was the control group which received general oral care. The incidence and severity of stomatitis after chemotherapy were recorded in both groups. The incidence and severity of stomatitis between the two groups was tested by 字2 test and Mann-Whitney test respectively. Result： The rate of stomatitis was 32% in the experimental group， while the control group was 74%. There was a significant difference between these two groups （字2=6.83， P=0.001）. All cases of stomatitis in both groups were OAG grade Ⅱ （mild-moderate stomatitis）， and showing the severity of the test group was lower than that of the control group， the severity of the grades was significantly different between the two groups （Z=-4.186， P=0.00）. Conclusion： The quality control circle activity has greatly reduced the incidence of stomatitis in breast cancer patients after chemotherapy， and it can be used as a routine oral care in chemotherapeutic patients with breast cancer.

[Key words] Quality control circle activity Breast cancer Chemotherapy Stomatitis Oral assessment guide

First-authors address： Fujian Tumor Hospital， Fuzhou 350014， China

乳腺癌常用的化療药物，如顺铂、环磷酰胺、5-氟尿嘧啶等，会导致口腔黏膜细胞受损、新生不当或因免疫抑制，从而引起口腔炎的发生[1-2]，常发生于化疗后4～7 d，7～14 d达高峰[3]。单纯执行化疗口腔黏膜炎发生率介于30%～75%[4]。患者口腔软组织及口腔黏膜发生炎症反应，甚至形成溃疡，造成口腔疼痛，进食困难，严重时将延长或中断化疗计划[1，5-6]，从而影响癌症患者的身心健康和生活质量。品管圈是指一组做同样的或类似的工作的人，定期会面，分析和解决工作中的问题[7]。……