[1]杨芳,方瑶,韩志武.改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响[J].第三军医大学学报,2020,42(02):215-218.
 YANG Fang,FANG Yao,HAN Zhiwu.Effect of improved oral care on oral health and incidence of ventilator-associated pneumonia in patients with mechanical ventilation[J].J Third Mil Med Univ,2020,42(02):215-218.
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改良口腔护理方法对机械通气患者口腔卫生状况及呼吸机相关肺炎发生率的影响(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第02期
页码:
215-218
栏目:
临床医学
出版日期:
2020-01-30

文章信息/Info

Title:
Effect of improved oral care on oral health and incidence of ventilator-associated pneumonia in patients with mechanical ventilation
作者:
杨芳方瑶韩志武
430010 武汉,中国人民解放军中部战区总医院汉口院区呼吸内科
Author(s):
YANG Fang FANG Yao HAN Zhiwu  

Department of Respiratory Medicine, General Hospital of Central Theater of PLA, Wuhan, Hubei Province, 430012, China

关键词:
口腔护理改良口腔护理呼吸机相关性肺炎过氧化氢负压吸引
Keywords:
oral care improved oral care ventilator-associated pneumonia hydrogen peroxide pressure suction
分类号:
R473.5;R563.1;R605.973
文献标志码:
A
摘要:

目的探讨改良口腔护理方法在改善重症监护室(ICU)行机械通气患者的口腔健康、降低罹患呼吸机相关性肺炎(ventilator-associated pneumonia, VAP)概率和促进患者脱机中的作用。方法选取2017年1月至2019年1月本院呼吸内科重症监护室(RICU)中接受有创机械通气治疗的88例患者作为研究对象,按随机数字表法分为2组,对照组44例,行常规口腔护理(棉球蘸漱口液擦拭),试验组44例,给予改良口腔护理(采用儿童牙刷蘸过氧化氢溶液刷牙,配合生理盐水负压吸引法冲洗)。观察患者口腔卫生状况及相关口腔疾病症状发生率、呼吸道及人工气道病原菌检出率、呼吸机相关性肺炎发生率及RICU住院周期。结果试验组患者口腔状况较好,口臭、牙龈肿痛、口腔溃疡等口腔问题发生率低于对照组(P<0.05),呼吸道病原体初筛阳性率更低,且试验组患者呼吸机相关性肺炎发生率更低,RICU住院时间更短(P<0.05)。结论与常规口腔护理相比,改良口腔护理对改善口腔卫生更有效,减少机会病原体的定植,降低呼吸机相关性肺炎发生概率,缩短患者ICU住院周期。
 

Abstract:

ObjectiveTo investigate the effect of improved oral care on oral health, incidence of ventilator-associated pneumonia and weaning from mechanical ventilation. MethodsEighty-eight patients receiving mechanical ventilation in the intensive care unit (ICU) of our department between January, 2017 and January, 2019 were enrolled in this study. The patients were randomized equally into control group and observation group to receive conventional oral care (using mouth wash) and improved oral care (brushing teeth with hydrogen peroxide and oral rinsing with saline and pressure suction), respectively. Oral health, positive rates of pathogenic microorganisms in the respiratory tract and the ventilator, the incidence of ventilator-associated pneumonia and the length of ICU time were compared between the 2 groups. ResultsCompared with those in the control group, the patients in the observation group had better oral condition and lower incidences of halitosis, gingival swelling and pain, and oral ulcer (P<0.05) and also lower detection rates of pathogenic microorganisms. The incidence of ventilator-associated pneumonia was significantly lower and the ICU time was significantly shorter in the observation group than in the control group (P<0.05). ConclusionCompared with conventional oral care, the improved oral care achieves better oral cleanliness to effectively reduce the risk of oral problems and the incidence of ventilator-associated infection and shorten the ICU time of the patients with mechanical ventilation.

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更新日期/Last Update: 2020-01-29