术前含漱口腔护理液对食管手术患者预防肺部感染的效果

Efficacy of oral rinses in preventing pulmonary infection of patients undergoing esophageal surgery

目的探讨术前不同口腔护理液对食管手术患者预防肺部感染的效果。方法 食管癌患者90例,随机分为3组,每组30例。A组用0.05%碘伏液口腔护理,B组用0.02%呋喃西林液口腔护理,C组用生理盐水口腔护理。术前1周,每天含漱5次。口腔干预后留取手术日晨咽拭子培养、术中气管插管2h痰标本、拔管后气管套囊黏附分泌物进行培养,分析比对细菌培养结果及对肺部感染的预防作用。结果咽拭子、痰标本、气管套囊黏附分泌物细菌培养阳性率:A组为30.0%、26.7%、20.0%,B组为63.3%、50.0%、56.7%,C组为80.0%、66.7%、76.7%;A、B、C组肺部感染发生率为20.0%、40.0%、56.7%,组间差异明显(P<0.01)。结论手术前使用0.05%碘伏液进行手术前口腔干预,可起到局部抑菌杀菌的作用,对预防食管手术患者肺部感染起到良好效果。

Objective To investigate the efficacy of different oral rinses in preventing pulmonary infection of patients undergoing esophageal surgery.Methods Ninety patients undergoing esophageal surgery were randomly divided into three groups with 30 cases each.The patients in group A rinsed orally with a rinse of 0.05% povidone-iodine in the moning of operation,those in group B with a rinse of 0.02% nitrofurazone,and those with a rinse of normal saline.Oral rinse was performed 5 times a day for 7 days before operation.The bacteria cultures of the throat swab on the morning of surgery（T1）,sputum taken at 2 h during intubation（T2）,and endotracheal tube adhesion properties after extubation（T3） were carried out.The incidence of pulmonary infection was recorded after operation.Results The positive rates of bacteria culture at T1,T2,T3 were 30.0%,26.7%,20.0% in group A,which were 63.3%,50.0%,56.7% in group B.The incidence rates of pulmonary infection were 20.0%,40.0%,56.7% in groups of A,B,C,respectively.The difference among three groups was significant（P0.01）.Conclusion Preoperative oral care with 0.05% povidone-iodine can effectively prevent lung infection in the patients undergoing esophageal surgery.