常规刷牙预防呼吸机相关性肺炎的效果观察

Prevention of ventilator-associated pneumonia by routine tooth-brushing

目的探讨常规刷牙在预防呼吸机相关性肺炎(VAP)中的作用,为寻找更为有效的口腔护理方法提供依据。方法将98例经口气管插管机械通气患者随机分为两组,对照组(48例)应用传统擦拭法进行口腔护理,观察组(50例)采用常规刷牙方法进行口腔护理;两组口腔护理后均给予口腔冲洗和咽部深吸引。比较两组机械通气1周后VAP发生率、机械通气时间及ICU住院时间。结果观察组机械通气1周后VAP发生率显著低于对照组(P<0.05),机械通气时间及ICU住院时间显著短于对照组(均P<0.01)。结论常规刷牙配合口腔冲洗及咽部深吸引能显著降低VAP的发生率,缩短机械通气及ICU住院的时间。

Objective To study the effect of routine tooth brushing on prevention of ventilator-associated pneumonia（VAP）,and to provide evidence for a better oral care method.Methods Totally,98 patients who were given oral endotracheal intubation for mechanical ventilation（MV） were randomly divided into an observation group（n=50） and a control group（n=48）.The control group were given conventional oral nursing care with chlorhexidine collutory,while the observation group received brushing of teeth with chlorhexidine collutory.After oral nursing care,patients in both groups received oral rinsing and laryngopharynx suctioning.The incidence of VAP on the 7th day of MV,the duration of MV and the length of ICU stay were compared.Results The incidence of VAP in the observation group was significantly lower than that in the control group on the 7th day of MV（P0.05）,the duration of MV and the length of ICU stay in the observation group were significantly shorter than those in the control group（P0.01 for both）.Conclusion Routine tooth brushing combined with oral rinse and laryngopharynx suction can prevent VAP effectively,and shorten duration of MV and the length of ICU stay significantly.