Мукозит полости рта как осложнение химиотерапии: методы лечения и профилактики

Актуальность. Оральный мукозит – одно из наиболее ранних и распространенных осложнений химиотерапии, ухудшающее качество жизни пациентов и ограничивающее лечение. Частота мукозита составляет 30–40%. Потенциально применение любого цитостатика может привести к возникновению мукозита. Пациенты с оральным мукозитом могут испытывать сильную боль, трудности с глотанием, изменение вкусовых ощущений, снижение веса и присоединение вторичных инфекций, что в тяжелых случаях может привести к несоблюдению режима лечения или стать дозолимитирующей токсичностью, требующей изменения схемы лечения или его прерывания. Цель исследования: изучение методов лечения и профилактики мукозита полости рта, вызванного химиотерапией, на основе анализа данных литературы.

Материалы и методы. Для достижения поставленной цели проведен тематический обзор литературы по ключевым словам: оральный мукозит, побочные эффекты химиотерапии, лечение орального мукозита, терапия орального мукозита, профилактика орального мукозита. Найдено 2999 публикаций, представленных в международных электронных научных базах PubMed, MEDLINE, NCBI, eLibrary.RU, Cyberleninka, Google scholar, Crossref. На основе критериев отбора было проанализировано 60 публикаций, содержащих результаты исследований методов лечения и профилактики мукозита полости рта, возникающего вследствие химиотерапии. Методология данного анализа соответствует стандартам, предъявляемым к систематическим обзорам и метаанализам (PRISMA).

Результаты. В 2020 году MASCC/ISOO опубликовали рекомендации по лечению мукозита, разделив методы на семь групп: базовый уход за полостью рта, противовоспалительные средства, фотобиомодуляция, криотерапия, антимикробные и анальгетические препараты, факторы роста и цитокины, натуральные средства. Однако, несмотря на разнообразие доступных средств, существующие терапевтические протоколы не всегда демонстрируют достаточную эффективность.

Заключение. Для повышения эффективности лечения орального мукозита необходимо продолжать научные исследования в данной области, разрабатывать инновационные терапевтические подходы и улучшать координацию между специалистами различных медицинских направлений.

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