口腔癌患者术后口干变化趋势及影响因素的纵向研究

doi:10.19439/j.sjos.2026.01.015

摘要/Abstract

摘要： 目的分析口腔癌患者术后口干的现状及其影响因素。方法选择2022年3月—2022年11月上海交通大学医学院附属第九人民医院140例口腔癌手术患者为研究对象。采用数字模拟评分表（Numberical Rating Scale, NRS）和非刺激唾液流量（Unstimulated Saliva Flow Rate, USFR）评估口腔干燥程度,采用口渴痛苦量表（Thirst Distress Scale, TDS）评估口渴程度,采用头颈癌生存质量问卷（Quality of Life Questionnaire-the Head and Neck Cancer Module, QLQ-H&N35）及焦虑自评量表（Self-rating Anxiety Scale, SAS）评估患者术后生活质量和心理状况。采用单因素和多因素回归分析NRS和USFR的影响因素。结果多因素分析结果显示,在口干严重程度方面,60岁以上比60岁以下NRS得分高（β=-0.133,P<0.001）;双侧切除下颌下腺比未切除/单侧下颌下腺切除者NRS得分高（β=-0.139,P= 0.002）;气管切开比未气管切开NRS得分高（β=-0.104,P=0.007）;术后禁饮5天及以上比5天以下NRS得分高（β=-0.099,P=0.002）;张口呼吸比无张口呼吸NRS得分高（β=-0.103,P=0.006）。术后QLQ-H&N35（β=0.007,P<0.001）及TDS（β=0.112,P<0.001）评分越高,口腔干燥越严重。在非刺激唾液流量方面,女性和男性相比USFR更低（β=0.009,P=0.045）;有饮酒史的患者USFR更低（β=-0.018,P=0.002）;术前化疗的患者USFR更低（β=0.015,P=0.006）;术前禁饮时长超过11 h的患者USFR更低（β=0.02,P=0.001）;气管切开比未气管切开患者USFR更低（β=-0.011,P=0.048）;术前USFR更低的患者,术后USFR更低（β=0.105,P<0.001）;TDS得分越高时,患者USFR越低（β=-0.006,P<0.001）。结论性别、年龄、下颌下腺切除、腮腺导管结扎、气管切开、术后禁饮时长、开口呼吸、术后生活质量以及口渴影响患者口腔干燥及唾液分泌,医护人员应早期识别并为开展减轻口腔干燥的护理措施提供依据。

关键词: 口腔癌, 术后口干, 影响因素, 纵向研究

Abstract: PURPOSE: To analyze the current status of postoperative xerostomia in patients with oral cancer and the contributory factors. METHODS: A total of 140 patients undergoing oral cancer surgery in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2022 to November 2022 were selected as the study objects. The Numberical Rating Scale(NRS) and Unstimulated Saliva Flow Rate(USFR) were used to assess the degree of oral dryness. Thirst level was assessed using the Thirst Distress Scale(TDS). The quality of life and psychological status of patients were evaluated by Quality of Life Questionnaire-the Head and Neck Cancer Module (QLQ-H&N35) and Self-rating Anxiety Scale. The influence factors of NRS and USFR were analyzed by univariate and multifactorial regression. RESULTS: The results of multifactorial analysis showed that in terms of dry mouth severity, patients more than 60 years old had higher NRS scores than those less than 60 years old(β=-0.133, P<0.001). Bilateral removal of submandibular gland had higher NRS score than those with unresected/unilateral submandibular gland removal(β=-0.139, P=0.002). Patients with tracheotomy had higher NRS score than those without tracheotomy(β=-0.104, P=0.007). The higher NRS scores for postoperative abstinence from drinking for five days or more(β=-0.099,P=0.002), higher NRS scores for open-mouth breathing(β=-0.103,P=0.006). Higher postoperative QLQ-H&N35(β=0.007,P<0.001) and TDS(β=0.112,P<0.001) scores were associated with more severe oral dryness. USFR was lower in females compared to males(β=0.009, P=0.045), patients with a history of alcohol consumption(β=-0.018, P=0.002), patients treated with preoperative chemotherapy(β=0.015, P=0.006), patients with more than 11h of preoperative abstinence from drinking(β=0.02, P=0.001), and tracheotomized patients(β=-0.011, P=0.048). Patients with lower preoperative USFR had lower postoperative USFR(β=0.105, P<0.001), patients with higher TDS scores had a lower USFR(β=-0.006, P<0.001). CONCLUSIONS: Gender, age, submandibular gland removal, parotid duct ligation, tracheotomy, length of postoperative abstinence from drinking, open-mouth breathing, postoperative quality of life, and thirst affected patients' oral dryness and salivation. Healthcare professionals should recognize early and provide a basis for developing care measures to reduce oral dryness.

Key words: Oral cancer, Postoperative xerostomia, Influencing factors, Longitudinal research

中图分类号:

R739.8

郭星铜, 侯黎莉. 口腔癌患者术后口干变化趋势及影响因素的纵向研究[J]. 上海口腔医学, 2026, 35(1): 88-94.

Guo Xingtong, Hou Lili. Investigation of postoperative xerostomia and contributory factors in patients with oral cancer[J]. Shanghai Journal of Stomatology, 2026, 35(1): 88-94.

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