Efficacy of three oral gargling protocols for Prevention of oral mucositis in acute leukemia during chemotherapy

항암화학요법 중 가글링 유형에 따른 급성백혈병 환자의 구강감염 예방효과에 관한 연구

Because the oral mucositis is often inevitable in acute leukemia patients during chemotherapy, the efforts must be made to keep these leukemia patients from oral mucositis. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. This quasi-experimental study was performed to compare the prohpylatic value of these oral care protocols. Thirty-nine subjects were assigned to one of three groups. The first group performed bivon-normal saline gargling protocol, the second group performed chlorhexidine gargling protocol, and the last contrast group kept traditonal gargling protocol. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count (ANC) reached $1,000/mm^3$. It continued about 2-4 weeks. The data was analyzed by ANCOVA and Kruskal-Wallis one way ANOVA, chi-sqare, survival analysis. The results were as follows : The contrast group showed significantly highest mean score of the OAG and Beck's perception of oral discomfort among three groups from second week to third week. However chie-test and survial analysis showed that the incidence of severe mucositis were not significantly different among three groups. Conclusively we recommend that nurses who care acute leukmia patients use bivon-normal saline gargling protocol be careful to occur severe mucositis during chemotherapy.