中国实用口腔科杂志 ›› 2026, Vol. 19 ›› Issue (1): 27-31.DOI: 10.19538/j.kq.2026.01.004

• 专题笔谈 • 上一篇    下一篇

放射性口腔黏膜炎的疾病管理模式

朱伟文,范    媛   

  1. 南京医科大学附属口腔医院黏膜病科,口腔疾病研究与防治国家及重点实验室培育单位(南京医科大学),江苏省口腔转化医学工程研究中心(南京医科大学),江苏 南京 210029
  • 出版日期:2026-01-30 发布日期:2026-01-30
  • 通讯作者: 范媛
  • 作者简介:范媛,教授、主任医师、博士研究生导师。现任南京医科大学附属口腔医院黏膜病科主任。兼任中华口腔医学会中西医结合专业委员会候任主任委员,江苏省中西医结合学会口腔专业委员会主任委员。擅长口腔黏膜疾病诊治,研究领域为口腔黏膜潜在恶性疾患的发病机制与防治,旨在发现新的疾病干预靶点和诊疗方法。主持国家自然科学基金项目4项、省部级科研项目2项。获江苏省医学新技术引进二等奖2项、江苏省科技进步奖二等奖、中华中医药学会科学技术奖二等奖等。
  • 基金资助:
    江苏省科技厅重点研发项目(社会发展)专项基金(BE2021723);江苏省卫健委面上项目(H2023149)

  • Online:2026-01-30 Published:2026-01-30

摘要: 放射性口腔黏膜炎(radiation-induced oral mucositis,RIOM)是头颈部肿瘤放疗、放化疗中常见且可限制治疗连续性的毒性反应,表现为口腔黏膜红斑、糜烂或溃疡、显著疼痛,常并发营养不良和感染。文章基于现有RIOM相关国内外指南和我国团体标准,提出一体化全周期管理模式:放疗前进行系统口腔评估、风险分层和健康教育;围疗程阶段以规范化口腔卫生管理为核心,辅以适宜的局部或全身预防措施;治疗阶段根据分级严重程度,综合应用镇痛、抗感染、营养支持和促愈合干预,必要时优化放疗计划;放疗后结合定期随访、患者报告结局(patient-reported outcome measures,PROMs)和质量改进(quality improvement,QI)指标,形成动态闭环。该模式旨在降低重度RIOM的发生率和治疗中断率,缩短愈合时间,并改善患者生活质量。

关键词: 放射性口腔黏膜炎, 风险评估, 临床分级, 临床质量改进

Abstract: Radiation-induced oral mucositis(RIOM)is a common toxic reaction that may limit continuous treatment in head-and-neck radiotherapy and chemoradiotherapy. It typically presents with oral mucosal erythema,erosions or ulcers,and severe pain,often accompanied by malnutrition and infection. Based on current national and international guidelines and the Chinese group standards,this paper puts forward an integrated,full-cycle management model,including:systematic oral evaluation,risk stratification,and health education before radiotherapy;standardized oral hygiene management supported by appropriate local or systemic prophylactic measures through the course of treatment;severity-based therapeutic strategies that combine analgesia,anti-infection,nutritional support,and pro-healing interventions during treatment,with radiotherapy plan optimized if necessary;regular follow-up combined with patient-reported outcome measures(PROMs)and quality improvement(QI)indicators to form a closed management loop. This model is designed to reduce the incidence of severe RIOM and treatment interruptions,accelerate healing,and improve patients′quality of life.

Key words: radiation-induced oral mucositis, risk assessment, clinical grading, clinical quality improvement

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