摘要
目的观察清新漱口水配合过氧化氢溶液进行口腔护理在有创机械通气重症患者的应用。方法选择2019年1—8月在本院行有创机械通气重症患者50例作为研究对象,均行常规护理,其中采用清新漱口水配合0.5%过氧化氢溶液进行口腔护理的25例患者为实验组,另25例仅采用0.5%过氧化氢溶液进行口腔护理的患者为对照组。观察两组患者病原菌分布情况、不同时间、不同部位病原菌定植情况及呼吸机相关性肺炎(VAP)发生率。结果实验组口咽部、呼吸机管壁部革兰氏阴性杆菌及革兰氏阳性杆菌定植占比明显少于对照组(P<0.05);有创机械通气72 h、168 h后,实验组口咽部及呼吸机管壁病原菌定植占比均显著低于对照组(P<0.05);对照组VAP发生9例(36.00%),实验组VAP发生3例(12.00%),组间差异具有统计学意义(χ^(2)=3.947,P=0.047)。结论清新漱口水配合过氧化氢溶液进行口腔护理可有效减少有创机械通气重症患者口腔及呼吸机管壁病原菌定植,降低VAP发生率。
Objective To observe the application of fresh mouthwash combined with hydrogen peroxide solution for oral nursing in critical patients undergoing invasive mechanical ventilation.Methods 50 critical patients who underwent invasive mechanical ventilation in our hospital between January and August 2019 were selected as study subjects,and all of them were given routine nursing for preventing ventilator associated pneumonia(VAP).Among them,25 patients receiving oral nursing using fresh mouthwash and 0.5%hydrogen peroxide solution were included in the experimental group,and the other 25 cases receiving oral nursing only using 0.5%hydrogen peroxide solution were included in the control group.The distribution of pathogenic bacteria,the colonization of pathogenic bacteria at different time and locations and the incidence of ventilators associated pneumonia(VAP)were observed in the two groups.Results The proportion of gram-negative and gram-positive bacilli in oropharynx and ventilator tube wall in experimental group was significantly lower than that in control group(P<0.05).After 72 h and 168 h of invasive mechanical ventilation,the proportion of pathogenic bacteria colonized in oropharynx and ventilator wall in experimental group was significantly lower than that in control group(P<0.05).There were 9 cases(36.00%)of VAP in the control group and 3 cases(12.00%)in the experimental group,and the difference between the two groups was statistically significant(χ^(2)=3.947,P=0.047).Conclusions The combination of refreshing mouthwash and hydrogen peroxide solution for oral care could effectively reduce microorganism colonization and the incidence of VAP in the oral cavity and ventilator wall of severe patients with invasive mechanical ventilation.
作者
陈玉格
姚忆培
Chen Yuge;Yao Yipei(Respiratory and critical care medicine center,the first affiliated hospital of Henan University of Science and Technology,Luoyang,Henan,471003,China)
出处
《齐齐哈尔医学院学报》
2021年第19期1747-1748,F0003,共3页
Journal of Qiqihar Medical University
关键词
清新漱口水
过氧化氢溶液
口腔护理
有创机械通气
呼吸机相关性肺炎
Fresh mouthwash
Hydrogen peroxide solution
Oral nursing
Invasive mechanical ventilation
Ventilator-associated pneumonia
