Aclinical Research Of Oral Cryotherapy Applied In Patients Receiving Bone Marrow Transplantation With Oral Mucositis

Object: This issue will pass the observation of clinical effect of oral cryotherapy on preventingthe bone marrow transplant patients with oral mucositis(OM), to seek the best oral cryotherapy intervention duration, to explore the effective oral cold therapy, to reduce transplant period oral mucositis, to improve patient quality of life during the transplant, and to provide strong evidence for clinical path establishing oral care patient bone marrow transplantation.Method: This study is a prospective random experiment, and the object of study are 60 patients who do the bone marrow transplantation first, age above 14 years old, have no oral infection, have the ability to read and write, have no ulcers and be based on preprocessing cheme with busulfan(Bu) plus cyclophosphamide(Cy) in the Department of Hematology of Second Hospital of Hebei Medical University. In this study, all subjects are given the conventional oral care during the transplantation, at the same time during infusing the cyclophosphamide in the pretreatment the patients are divided into experimental group and control group according to whether are given oral cryotherapy nursing intervention studies, and the experimental group according to the different of the cold treatment nursing intervention’s duration is divided into the experimental group(1) and experimental group(2), according to the method of random number table grouping. Due to its active metabolite of cyclophosphamide, the half-life of drug elimination is 7 hours. Accordingly, the patients in the experimental group(1) begin to be intervened for the oral cryotherapy from infusing the cyclophosphamide to the end of infusing the drug, the length of the time is 2 hours and the total case is 20; the patients in the experimental group(2) begin to be intervened for the oral cryotherapy from infusing the cyclophosphamide to the end of drug metabolism, the length of the time is 7 hours and the total case is also 20. Observe the case of OM of the patients, and analyze the data using the statistical software SPSS19.0.Result:1 According to the oral mucositis assessment of WHO and oral assessment guide(OAG), the incidence rate of oral mucositis in the experimental group(1) is 51.75%, the incidence rate of oral mucositis in the experimental group(2) is 37.75%, the incidence rate of oral mucositis in the control group is 66.5%. The oral mucositis incidence of patients in three groups is statistically difference(χ2=16.171, P<0.001). Oral mucositis between the experimental group(1) and experimental group(2) is a statistical difference(χ2=3.96,P<0.05), the incidence between the experimental group(1) and the control group is statistically difference(χ2=4.276, P<0.05), oral mucositis incidence between the experimental group(2) and the control group is statistically difference(χ2=16.172, P<0.05).2 The experimental group(2) can effectively control the occur of the above grade 3 mucositis, the three groups have significant difference(χ2=20.714, P<0.001). Severe oral mucositis between the experimental group(1) and experimental group(2) is a statistical difference(χ2=5.530, P<0.05), the severe oral mucositis incidence between the experimental group(1) and the control group is statistically difference(χ2=5.188,P<0.05), severe oral mucositis incidence between the experimental group(2) and the control group is statistically difference(χ2=20.212,P<0.05).3 Three groups of patients with diarrhea effect have significant difference(χ2=50.955,P<0.001). Between different groups in the experimental group, the experimental group and the control group of patients with diarrhea during transplantation compared to the situation, t test statistics show that between the experimental group(1) and experimental group(2), the experimental group and the control group have the significant difference(P<0.05). During the oral cryotherapy transplantation with different duration has effect on the diarrhea of the patients, the diarrhea frequency in experimental group significantly is higher than the control group, thus oral cryotherapy can increase patients’ diarrhea frequency.Conclusion:1 Oral cryotherapy can effectively reduce the incidence of oral mucositis in patients with bone marrow transplantation. And in the way of severe oral mucositis prevention, long-time cryotherapy effect better than short-time cryotherapy.2 During the oral cryotherapy, long-time cryotherapy can cause diarrhea occurred more easily than short-time cryotherapy by the patients of bone marrow transplantation.