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<p>To investigate the implications of salivary pH for the occurrence of oral mucositis (OM) in patients with hematological diseases during consolidation chemotherapy with high-dose cyclidine, and to evaluate the effect of personalized alkalization care guided by dynamic pH monitoring on the healing of oral ulcers in acidic subgroups. The study was conducted using a two-stage design. The first phase was a prospective cohort observation, which included 100 patients who received high-dose cytiabine (≥ 2&#xa0;g/m<sup>2</sup>/ time) consolidation chemotherapy in the hematology department of a hospital from May 2024 to May 2025. They were uniformly given basic oral care and saliva pH and OM grades were recorded daily. OM was determined based on the occurrence of WHO oral mucositis grade ≥ 2 within a 28-day cycle. In the second stage, patients who developed OM in the first stage were selected for persistent acidic microenvironment (pH &lt; 6.0 for ≥ 3 consecutive days), and randomized controlled trials (1:1 area randomization) were conducted to compare ulcer healing time between “pH monitoring guided alkalization care” and “routine care”, and to observe pH changes and pain VAS scores on the 3rd and 7th days after intervention. Statistical analysis, in addition to the conventional intergroup comparisons, supplemented multivariate models were used to adjust for outcomes (Logistic regression in the first stage, Cox regression or generalized linear model in the second stage), and effect sizes and 95% confidence intervals were reported. In the first stage, there were 53 cases of OM occurrence and 47 cases of no OM occurrence. The baseline pH difference was not statistically significant (6.32 ± 0.42 vs. 6.17 ± 0.39, <i>P</i> = 0.067). In the second stage, a total of 34 cases were included in the acidic subgroup, 20 in the intervention group, and 14 in the conventional group; The ulcer healing time in the intervention group was shorter than that in the conventional group (6.8 ± 1.2 d vs. 11.3 ± 2.1 d, <i>P</i> &lt; 0.001), and the pH on the third day after intervention was higher than that in the conventional group (6.55 ± 0.15 vs. 6.09 ± 0.19, <i>P</i> &lt; 0.001). A single baseline pH is difficult to serve as a universal early warning indicator for OM occurrence; In the persistent acidic microenvironment subgroup, personalized alkalization care guided by dynamic pH monitoring can accelerate the return of the oral microenvironment to neutrality and shorten the ulcer healing cycle.</p>

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Application of personalized nursing based on dynamic monitoring of oral pH in oral management of patients with hematological diseases undergoing chemotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Xiao Zhang,
  • Guoping Ren,
  • Weiwei Qin,
  • Zhuo Wan,
  • Hua He,
  • Wangbing Xue,
  • Chenguang Zhou,
  • Jizhen Yang

摘要

To investigate the implications of salivary pH for the occurrence of oral mucositis (OM) in patients with hematological diseases during consolidation chemotherapy with high-dose cyclidine, and to evaluate the effect of personalized alkalization care guided by dynamic pH monitoring on the healing of oral ulcers in acidic subgroups. The study was conducted using a two-stage design. The first phase was a prospective cohort observation, which included 100 patients who received high-dose cytiabine (≥ 2 g/m2/ time) consolidation chemotherapy in the hematology department of a hospital from May 2024 to May 2025. They were uniformly given basic oral care and saliva pH and OM grades were recorded daily. OM was determined based on the occurrence of WHO oral mucositis grade ≥ 2 within a 28-day cycle. In the second stage, patients who developed OM in the first stage were selected for persistent acidic microenvironment (pH < 6.0 for ≥ 3 consecutive days), and randomized controlled trials (1:1 area randomization) were conducted to compare ulcer healing time between “pH monitoring guided alkalization care” and “routine care”, and to observe pH changes and pain VAS scores on the 3rd and 7th days after intervention. Statistical analysis, in addition to the conventional intergroup comparisons, supplemented multivariate models were used to adjust for outcomes (Logistic regression in the first stage, Cox regression or generalized linear model in the second stage), and effect sizes and 95% confidence intervals were reported. In the first stage, there were 53 cases of OM occurrence and 47 cases of no OM occurrence. The baseline pH difference was not statistically significant (6.32 ± 0.42 vs. 6.17 ± 0.39, P = 0.067). In the second stage, a total of 34 cases were included in the acidic subgroup, 20 in the intervention group, and 14 in the conventional group; The ulcer healing time in the intervention group was shorter than that in the conventional group (6.8 ± 1.2 d vs. 11.3 ± 2.1 d, P < 0.001), and the pH on the third day after intervention was higher than that in the conventional group (6.55 ± 0.15 vs. 6.09 ± 0.19, P < 0.001). A single baseline pH is difficult to serve as a universal early warning indicator for OM occurrence; In the persistent acidic microenvironment subgroup, personalized alkalization care guided by dynamic pH monitoring can accelerate the return of the oral microenvironment to neutrality and shorten the ulcer healing cycle.