Immunological Study on Oral Health Care for Gastroenterological Cancer Patients at Surgery

• Published in: The Japanese Journal of Dysphagia Rehabilitation Vol. 16; no. 1; pp. 50 - 56
• Main Author: NOMURA, Ryoko
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Dysphagia Rehabilitation 30.04.2012; 一般社団法人 日本摂食嚥下リハビリテーション学会
• Subjects: gastroenterological cancer; NK cell activity; NK 細胞活性; number of oral bacteria; oral health care; surgical patients; 口腔ケア; 口腔内細菌数; 手術患者; 消化器がん
• ISSN: 1343-8441; 2434-2254
• DOI: 10.32136/jsdr.16.1_50

Oral care provided during the perioperative period has beneficial effects on ventilator associated pneumonia and surgical site infection, and is recommended for surgical patients. Reduction of oral bacteria is considered to be an important factor to prevent infectious complications, but the immune function and nutritional condition also appear to be involved in such prevention. In this study, it was hypothesized that the immune function is also responsible for the mechanism of the effect of oral care. We evaluated the number of oral bacteria, and NK cell activity levels, adopted as an index of the immune function.The study subjects consisted of 36 patients undergoing surgery for gastroenterological cancer. They were assigned to a control group (patients themselves or care workers were involved in oral hygiene as before) or an oral care group (dentists provided oral care once before admission, and primarily once a day on days 2 through 6 postoperatively). The number of oral bacteria, NK cell activity levels, and prealbumin levels were evaluated.As a result, the number of oral bacteria in the control group was larger on day 7 postoperatively than before surgery, whereas that in the oral care group did not increase. NK cell activity levels in the control group were lower on day 7 postoperatively than before surgery, but that in the oral care group could be maintained. Prealbumin levels markedly decreased in both groups.In gastroenterological cancer patients with severe postoperative wasting, in whom autopurification was not likely to function, we could inhibit the growth of oral bacteria through oral care provided by dentists during the perioperative period. Also, NK cell activity could be maintained, possibly due to the influence of social support on immune function.It is desirable to disseminate oral care for perioperative patients with gastroenterological cancer.