口腔黏膜改變患者之照護

Oral Care of Patients with Oral Mucous Membrane Altered

接受化學治療或頭頸部放射線治療的病患約有一半左右的病人經歷“口腔黏膜改變”的問題。病患一旦經歷口腔黏膜損傷，會由起初輕微的口乾以致嚴重疼痛，進而減少飲食及液體攝取、味覺降低、吞嚥困難等，使得自尊、身體心像受損及產生社會隔離的情形。加之病患抵抗力不足，造成系統性感染，便是導致癌症病患死亡的原因。就口腔黏膜改變的病患而言，口腔照護是主要獨立性護理措施，有效及完善的口腔照護有助於病患維持口腔於一正常功能狀態，目前臨床照護口腔炎之清潔技術、工具及頻率不盡相同，且無一合適評估口腔黏膜變化的工具。故在此引證口腔照護相關文獻，提供臨床護理人員參考及行為修正，期能為病患規劃出標準、完善之口腔照護計劃，以彰顯護理照護品質。

Half of all cancer patients experience oral mucous membrane changes during chemotherapy or radiotherapy. Often mild thirst is the first symptom they experience. Other symptoms include a reduced sense of taste, severe pain, and difficulty swallowing. Progression of symptoms results in decreased intake and can lead to low self-esteem, body image changes, and social isolation. Moreover, immune insufficiency may cause systemic infections and death. For patients with oral mucous membrane altered, oral care is the main independent nursing intervention. Effective and complete oral hygiene helps maintain the cancer patient's normal oral cavity status. However, current nursing care standards for cleaning techniques and tools and for frequency of care for stomatitis vary. Moreover, an appropriate assessment tool is also lacking. Therefore, the purpose of this paper was to review the literature in order to provide references and information for nurses who care for cancer patients with oral mucous changes. Findings will help nurses develop uniform nursing care standards so that they can develop and implement a plan for appropriate oral hygiene and improve the quality of care for cancer patients.