口腔冲洗联合气囊上滞留物冲洗引流对呼吸机相关性肺炎发病的影响研究

A study of the impact of oral washing combined with subglottic secretion drainage on prevention of ventilator-associated pneumonia

目的:探讨口腔冲洗联合气囊上滞留物冲洗引流对呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)发病的影响。方法:选取呼吸重症监护病房(RICU)2009年1月至2011年6月行机械通气的患者120例,随机分为干预组和对照组各60例,干预组给予定时口腔冲洗和气囊上滞留物冲洗引流,对照组行口腔擦拭,未行口腔冲洗,未定时冲洗气囊上滞留物。结果:干预组VAP发生率18.3%,对照组VAP发生率38.3%;VAP患者咽拭子、气囊上滞留物和下呼吸道分泌物优势菌符合率为47.1%,气囊上滞留物与下呼吸道分泌物优势菌符合率为61.8%。结论:口腔冲洗联合气囊上滞留物冲洗引流可降低VAP发生率,是预防VAP行之有效的重要方法。

Objective： To explore the impact of oral washing combined with subglottic secretion drainage （SSD） on the incidence of ventilator- associated pneumonia （VAP） .Methods： We selected 120 mechanical ventilated patients in RICU from January 2009 to June 2011, which were randomly divided into intervention group and control group, with 60 cases of patients in each group. Patients in the intervention group received oral washing and SSD, while those in the control group received oral wipe, without oral washing and SSD. Results：The incidence of VAP was 18.3% in intervention group and 38.3% in control group. In VAP patients, the coincidence rate of predominant flora in pharynx mop, sttbglottic secretion and lower respiratory tract secretion was 47.1% while that in subglottic secretion and lower respiratory tract secretion was 61.8%. Conclusion： Oral washing combined with subglottic secretion drainage can reduce the incidence of VAP. It is an effective method for the prevention of VAP.