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目的:探讨两种口腔护理方法对经口气管插管机械通气患者发生呼吸机相关性肺炎(VAP)的预防干预效果,为选择合适的口腔护理方法提供理论支持。方法:将2014年10月~2015年10月在我院ICU病房经口气管插管进行机械通气治疗的患者90例随机等分为观察组和对照组,观察组患者采取全面的口腔卫生护理,包括刷牙、吸痰、碳酸氢钠及0.02%醋酸氯己定溶液冲洗;对照组患者给予传统的护理方法,包括棉球擦拭和0.02%醋酸氯己定溶液冲洗。观察两组患者的口腔卫生状况、口腔溃疡发生情况及VAP发生情况。结果:观察组患者口腔异味发生的概率和牙菌斑指数均低于对照组(P<0.05)。观察组患者口腔溃疡及VAP发生率均低于对照组(P<0.05)。结论:采取全面的口腔卫生护理方法比传统的口腔护理方法对减少口腔细菌定植数量的效果更加明显,从而降低VAP的发生率。
Objective: To explore the preventive effects of two oral care methods on ventilator-associated pneumonia (VAP) in patients with mechanical ventilation through orotracheal intubation, and to provide theoretical support for the selection of suitable oral care methods. Methods: From October 2014 to October 2015, 90 patients with mechanical ventilation through oral intubation in ICU ward of our hospital were randomly divided into observation group and control group. Patients in observation group were given comprehensive oral hygiene care, Including brushing, suctioning, sodium bicarbonate and 0.02% chlorhexidine acetate solution washing; control group of patients given traditional nursing methods, including cotton ball wipe and 0.02% chlorhexidine acetate solution washing. Oral health status, oral ulcer occurrence and VAP incidence were observed in two groups. Results: The odds of oral malodour and plaque index in observation group were lower than those in control group (P <0.05). Oral ulcers and VAP incidence in observation group were lower than those in control group (P <0.05). CONCLUSIONS: The use of a comprehensive oral hygiene approach is more effective than traditional methods of oral care in reducing the number of colonized oral bacteria, thereby reducing the incidence of VAP.