改良口腔护理对经口气管插管患者的效果观察

发布时间：2018-03-14 01:15

本文选题：气管插管　切入点：机械通气　出处：《护士进修杂志》2012年24期 　论文类型：期刊论文

【摘要】：目的探讨改良口腔护理对经口气管插管机械通气患者的临床护理效果,以提高护理质量。方法选取我院ICU 2010年2月～2012年3月经口气管插管机械通气住院患者70例,随机分为观察组及对照组各35例。观察组插管前口腔擦洗1次,插管后采取刷洗加冲洗(3次/d);对照组采用传统口腔擦洗法(3次/d)。全部患者在插管前、插管后4h、12h、24h、48h分别采集咽拭子进行细菌菌落计数,插管后第1天起分别行痰标本及咽拭子(1次/3d)定性培养,分析两组口咽部细菌变化及VAP发生率。结果全部70例患者中,有效病例61例,发生VAP15例,死亡8例。实验组31例、VAP4例、死亡3例,对照组30例、VAP11例、死亡5例。两组VAP发生率差异有显著意义(P0.05),两组死亡率差异无显著意义(P0.05)。两组插管前口腔菌落计数差异无显著意义(P0.05),插管后4h、12h、24h、48h口腔菌落计数差异有显著意义(P0.05)。结论改良口腔护理方法可有效减少经口气管插管患者口咽部细菌生长,降低VAP发生率,可明显提高口腔护理质量。
[Abstract]:Objective to explore the clinical nursing effect of improved oral nursing for patients undergoing mechanical ventilation through oral tube intubation, and to improve the quality of nursing. Methods 70 patients with mechanical ventilation of oral tube intubation from February 2010 to 2012 in our hospital were selected from February 2010 to 2012. Each group was randomly divided into observation group (n = 35) and control group (n = 35). Before intubation, oral cavity was scrubbed once in the observation group, then brushed and rinsed three times per day after intubation, while the control group was treated with traditional oral scrubbing method for 3 times / d. All the patients were treated before intubation. Pharynx swabs were collected for bacterial colony count at 4 h, 12 h, 24 h and 48 h after intubation. Sputum specimens and pharynx swabs were cultured qualitatively on the first day after intubation. The changes of oropharyngeal bacteria and the incidence of VAP in both groups were analyzed. There were 61 cases of effective VAP15, 8 cases of death, 31 cases of VAP in experimental group, 3 cases of death, and 30 cases of VAP in control group. The incidence of VAP in the two groups was significantly higher than that in the control group (P 0.05), but there was no significant difference in the mortality between the two groups (P 0.05). There was no significant difference in the count of oral colony before intubation between the two groups (P 0.05), but there was no significant difference in the count of oral colony before intubation between the two groups (P 0.05), and there was a significant difference between the two groups in the count of oral colony before intubation (P 0.05) and 24 h after intubation (P 0.05). The improved oral nursing method can effectively reduce the growth of bacteria in oropharynx in patients with oral tube intubation. Reducing the incidence of VAP can significantly improve the quality of oral care.
【作者单位】：南昌大学医学院研究生院;广东省深圳市第七人民医院;
【分类号】：R472

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