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目的探讨重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)联合复方氯己定治疗急性髓系白血病(AML)诱导化疗并发口腔黏膜炎(OM)的临床疗效及安全性。方法收集2012年5月至2015年6月于本院血液内科接受诱导化疗后并发OM的AML患者50例,随机分为对照组和观察组,每组25例。对照组患者应用复方氯己定含漱液含漱,观察组患者应用复方氯己定含漱液和含rhGM-CSF的含漱液交替含漱,分析比较两组患者的疗效,观察并记录不良反应发生情况。结果观察组和对照组患者OM愈合所需时间和口腔细菌感染率差异无统计学意义(P>0.05),但观察组口腔真菌感染率及肠外营养支持使用率均明显低于对照组,差异有统计学意义(P<0.05),且观察组显效率明显高于对照组,差异有统计学意义(P<0.01)。两组未见严重不良反应。结论采用含rhGM-CSF的含漱液联合复方氯己定含漱液可有效地治疗化疗相关OM,显著降低口腔真菌感染率,促进口腔黏膜恢复。
Objective To investigate the clinical efficacy and safety of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) and compound chlorhexidine in the treatment of acute myeloid leukemia (AML) -induced chemotherapy combined with oral mucositis (OM). Methods A total of 50 patients with AML who underwent OM after receiving induction chemotherapy in our department from May 2012 to June 2015 were randomly divided into control group and observation group with 25 cases in each group. Patients in the control group were treated with compound chlorhexidine gargle. Patients in the observation group were treated with compound chlorhexidine gargle and gargle containing rhGM-CSF alternately. The curative effect was compared and analyzed between the two groups. Observe and record the bad Reaction occurred. Results There was no significant difference between the time required for OM healing and oral bacterial infection in the observation group and the control group (P> 0.05). However, oral fungal infection rate and parenteral nutrition support rate in the observation group were significantly lower than those in the control group (P <0.05), and the effective rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P <0.01). No serious adverse reactions were seen in both groups. Conclusion Gargle containing rhGM-CSF combined with compound chlorhexidine gargle can effectively treat chemotherapy-related OM, significantly reduce oral fungal infection rate and promote oral mucosal recovery.