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KMID : 0367020180300040362
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Journal of Korean Academic of Adult Nursing
2018 Volume.30 No. 4 p.362 ~ p.375
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Effect of Oral Cryotherapy for Reducing Oral Mucositis in Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-analysis
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Park Seong-Hi
Han Su-Ha
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Abstract
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Purpose: This systematic review and meta-analysis provided scientific evidence for oral cryotherapy as a nursing intervention for the prevention of Oral Mucositis (OM) associated with Hematopoietic Stem Cell Transplantation (HSCT).
Methods: The literature search was carried out in July and October 2017. The MEDLINE, EMBASE, Cochrane Library, CINAHL, and KoreaMed electronic databases were searched using the MeSH keywords “mucositis” and “cryotherapy.” The Cochrane's Risk of Bias tool was used to assess the internal validity of the Randomized Controlled Trials (RCTs). The selected studies were included in the meta-analysis using Review Manager 5.3.
Results: Among seven RCTs with 264 patients, oral cryotherapy significantly decreased the incidence of OM (Relative Risk [RR]=0.46, 95% Confidence Interval [CI]=0.31~0.66), including severe OM (grade 2~4: RR=0.33, 95% CI=0.21~0.52; grade 3~4: RR=0.34, 95% CI, 0.22~0.53), and also reduced the OM severity score (Standardized Mean Difference [SMD]=?0.92, 95% CI=?1.25~?0.58). In addition, the need of intravenous narcotics therapy (RR=0.19, 95% CI=0.07~0.51) and the total parenteral nutrition (RR=0.54, 95% CI=0.35~0.84) were reduced. These results were associated with a significantly reduced length of hospitalization (Weighted Mean Difference [WMD]=?1.22, 95% CI=?2.37~?0.07).
Conclusion: Oral cryotherapy is effective and well-tolerated nursing intervention to alleviate OM among patients receiving myeloablative therapy before HSCT. Nurses caring for patients treated with myeloablative therapy should place high priority to prevent OM based on this evidence.
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KEYWORD
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Mucositis, Cryotherapy, Stem cell transplantation, Meta-analysis
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