口服管理与血液造血干细胞移植后的并发症之间的关联
Noyuri Yamaji1,2, Kojiro Morita3, Sachiko Ono4
1Institute of Clinical Epidemiology, Showa Medical University, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8555, Japan. yamaji.n@med.showa-u.ac.jp.
概括
在血造干细胞移植 (HSCT) 之前进行移植前口服治疗并没有显著减少严重的口腔粘膜炎或死亡率. 然而,它与移植后感染的发病率降低有关.
科学领域:
- 血液学 血液学 血液学
- 移植医学 移植医学
- 口腔健康 口腔健康
背景情况:
- 造血干细胞移植 (HSCT) 存在口腔粘膜炎和感染的风险,这是由于密集的调节和免疫抑制.
- 建议在移植前进行口服治疗,但其在缓解这些并发症方面的有效性尚未得到充分证实.
研究的目的:
- 调查HSCT之前的牙科管理与严重口腔粘膜炎,感染和死亡率的结果之间的联系.
- 在大量患者队列中评估HSCT前口腔护理的有效性.
主要方法:
- 一个回顾性队列研究,利用日本全国性住院诊断程序组合数据库.
- 使用1:1的倾向性得分匹配,将接受HSCT前口服治疗的患者与没有接受口服治疗的患者进行比较.
- 评估的结果包括严重口腔粘膜炎的持续时间,感染的发生率和30天住院死亡率.
主要成果:
- 在15911名患者中,34.9%接受了HSCT前的口服治疗;分析了4945个匹配对.
- 两组之间在严重口腔粘膜炎的持续时间或30天死亡率方面没有发现显著差异.
- 在HSCT前接受口服治疗的患者表现出统计学上显著的感染发病率降低 (55.1%与59.5%相比).
结论:
- 牙医在HSCT前进行口服治疗可能不会减少严重口腔粘膜炎的持续时间或整体死亡率.
- 在HSCT前的口服治疗似乎减少了移植后感染的发生率.
- 需要进一步的研究来确定特定的口腔护理成分,以优化粘膜炎和死亡率的结果.
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