口腔护理中应用选择性口咽部脱污染对机械通气患者的影响

目的探讨在口腔护理中应用选择性口咽部脱污染(selective oropharyngeal decontamination,SOD)技术对机械通气患者的影响。方法选择2010年2月-2011年1月本院ICU实施机械通气治疗48h以上的患者120例,随机分为实验组和对照组,每组各60例。对照组采用常规护理,实验组在此基础上在口腔护理中应用SOD技术,比较两组患者咽拭子培养及下呼吸道分泌物培养阳性率、呼吸机相关性肺炎(ventilator associated pneumonia,VAP)及死亡的发生率。结果实验组患者咽拭子培养及下呼吸道分泌物培养阳性率及VAP发生率低于对照组(均P<0.05)。结论在口腔护理中应用SOD技术,可以有效清除部分口咽部定植菌,降低VAP发生率,值得临床推广应用。

Objective To investigate the clinical practice of selective oropharyngeal decontamination（SOD） and oral care in patients with mechanical ventilation. Methods 120 patients with more than 48 hours mechanical ventilation from February 2010 to January 2011 were randomly grouped to the experimental group and the control group in equal number.The control group was nursed normally, and the experimental group received SOD in oral care besides normal nursing. The two groups were compared in terms of positive rate of oropharyngeal swab macroflora colonized, the occurrence of ventilator associated pneumonia（VAP） and the mortality. Results Compared to controls, the experimental group had the lower positive rate of oropharyngeal swab macroflora colonized and the lower occurrence of VAP（all P 0.05）. Conclusion The SOD may take the germicidal actions effectively and reduce the occurrence of VAP.