嚼食檳榔及抽菸情形與口腔黏膜病變關係之探討

本研究的主要目的是探討社區中嚼食檳榔及抽菸行為與口腔黏膜病變盛行之相關性，由過去對高雄市在一般社區中的高危險群口腔黏膜病變盛行情形，發現篩檢出的病變種類最多者為白斑症（11.25﹪），其次是檳榔黏膜症（10.20﹪），第三為口腔黏膜下纖維化（3.75﹪），高雄市檳榔、菸使用率有上升趨勢，且大多以勞動階級為主，因清潔隊員工大多是勞動者，因此本研究特選定該群體，以了解口腔黏膜病變之關係。本研究請口腔外科醫師及經過專門訓練之牙醫師擔任口腔黏膜篩檢工作，另填寫檳榔、菸使用量問卷。共檢查了1979位清潔隊員工，其中男女性相當（各佔48.8﹪、51﹪），年齡層分佈以35-49歲居多（52.5﹪），曾有嚼食檳榔習慣者有19.5﹪，曾有抽菸者中有28.3﹪，研究發現疑似口腔黏膜疾病需進一步檢查的有13.5﹪（267人），其中篩檢出的病變種類最多者依序為白斑症（4.7﹪）、檳榔黏膜症（4.6﹪）、口腔黏膜下纖維化（1.9﹪）。同時由嚼食檳榔種類探討與罹病情形有明顯影響，以「僅嚼食荖葉檳榔」罹患口腔黏膜疾病49.6﹪為最高，「僅嚼食荖花檳榔」為27.5﹪，顯示嚼食荖葉檳榔對口腔黏膜較荖花檳榔更具危險性。各種疾病盛行率以同時有嚼食檳榔及抽菸者為最高（44.7﹪），其次為嚼食檳榔者（37.0﹪），僅抽菸者再次之（17.2﹪）。本研究結果顯示應針對使用檳榔、菸高危險群之民眾，有規劃性之篩檢，陽性個案確實追蹤，協助就醫及早確診、早期治療，期使個案能獲得妥適醫療，對身體的傷害降至最低。

關鍵字

白斑症；檳榔黏膜症；口腔黏膜下纖維化

並列摘要

This purpose of this research was to investigate the association between areca/betel quid chewing and cigarette smoking behavior with oral mucosal lesions. A previous investigation had shown that for the oral lesion high risk group in communities, leukoplakia was the most common lesion, followed by betel chewer’s mucosa and OSF. Hence, it is crucial to understand the health conditions of oral cavity and the relationship with habits of areca/betel chewing and cigarette smoking. The blue collar class had higher prevalence rate or areca/betel chewing. Therefore, the employees of the Bureau of Environmental Protection in Kaohsiung city were recruited for this study There were totally 1979 participants recruited. Each participant received a detailed oral examination and a personal interview. The proportions for men and women were 49% and 51%, respectively. Around half of the participants (52.5%) were between 35 to 49 years old. Our research found that 13.5% of subjects had at lease one oral mucosal lesions. The prevalence rates of areca/betel quid chewing and cigarette smoking were 19.5% and 28.3%, respectively. The most common lesion was leukoplakia (4.7%), followed by betel chewer’s mucosa and OSF. The subjects with both areca/betel quid chewing and cigarette smoking habits have the highest probability to have oral mucosal lesions. We found that chewing different types of quid were also related to the prevalence rates of oral mucosal lesions. People who chewed betel quid had higher prevalence rates of oral lesions than areca quid (49.6% vs. 27.5%). Participants with both areca/betel quid chewing and cigarette smoking effects had the highest percentage of oral mucosal lesions (44.7%). The only chewing habit had the second highest percentage of oral lesions (37.0%), and followed by the smokers with 17.2% of lesions. Our research indicated that we should enhance the importance of oral mucosal lesion screening in the high-risk group to early detection of lesions. Besides, we should ensure the oral lesions cases’ follow-up in order to reducing the subsequent complication.