预防呼吸机相关性肺炎口咽部清洁方法研究

发布时间：2018-10-21 14:53

【摘要】：目的探讨口咽部清洁方法预防呼吸机相关性肺炎及口腔感染的效果,以降低口腔感染率。方法选取医院2013年1月-2014年1月123例呼吸机辅助呼吸治疗患者,按随机数字表法将其分为3组,每组各41例,A组采用喉镜直视下电动牙刷清洁;B组采用传统口腔擦洗联合口腔冲洗;C组采用传统口腔擦洗,比较3组患者口腔清洁效果。结果经3种不同方法清洁口腔后,A、B、C组口咽部清洁总有效率分别为97.56%、80.49%、65.85%,组间比较差异有统计学意义(P0.05);A、B、C组牙菌斑指数分别为(1.02±0.02)、(1.62±0.56)、(2.38±0.24)分,组间比较差异均有统计学有意义(F=6.37,P0.05);A组口腔异味、口腔炎、口腔溃疡和呼吸机相关性肺炎发生率明显低于B、C两组,且B组发生率明显低于C组,比较差异有统计学意义(P0.05)。结论喉镜直视下电动牙刷清洁口咽部效果更佳,明显改善呼吸机辅助呼吸患者口腔异味和牙菌斑,且在呼吸机相关性肺炎和口腔感染的预防中具有重要的临床价值。
[Abstract]:Objective to study the effect of oropharynx cleaning method in preventing ventilator-associated pneumonia and oral infection in order to reduce oral infection rate. Methods 123 patients with ventilator assisted respiratory therapy from January 2013 to January 2014 were randomly divided into 3 groups. There were 41 cases in each group, A group was cleaned by electric toothbrush under laryngoscope, B group was treated with traditional oral scrub combined with oral lavage, and C group was treated with traditional oral scrub to compare the efficacy of oral cleaning in 3 groups. Results after cleaning oral cavity with three different methods, the total effective rate of oral and pharyngeal cleaning was 97.566,80.49 and 65.85, respectively (P0.05), and the plaque index was (1.02 卤0.02), (1.62 卤0.56), (2.38 卤0.24) in group A (P 0.05). The incidence of stomatitis, oral ulcer and ventilator-associated pneumonia was significantly lower in group B than that in group B (P0.05). Conclusion the electric toothbrush under laryngoscope is more effective in cleaning the oropharynx and can improve the oral odour and plaque in the patients with ventilator assisted breathing. It has important clinical value in the prevention of ventilator-associated pneumonia and oral infection.
【作者单位】：河南省肿瘤医院重症医学科;
【基金】：国家自然科学基金资助项目(81370661)
【分类号】：R563.1

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