吸入糖皮质激素引致口腔念珠菌病的护理

Nursing care of oral candidiasis caused by inhaled corticosteroids

[目的]探讨吸入糖皮质激素引致口腔念珠菌病的护理对策。[方法]回顾性总结2009年1月—2010年12月在我院呼吸科收住的吸入糖皮质激素后出现口腔念珠菌病的老年病人,并依据是否使用3%碳酸氢钠液漱口随机将病人分为两组:对照组47例雾化吸入糖皮质激素治疗后给予生理盐水漱口;观察组50例雾化吸入糖皮质激素治疗后给予3%碳酸氢钠液漱口。总结对比两组病人的口腔拭子培养阳性标本数、出现口腔白斑覆盖的时间并进行分析。[结果]观察组口腔拭子培养阳性标本比例18%明显低于对照组的78.7%,口腔白斑覆盖比例16%明显低于对照组的74.4%,差异均有统计学意义(P<0.05)。观察组出现口腔拭子培养阳性标本的时间7.7d±2.3 3d,明显晚于对照组的5.7d±1.71d,口腔白斑覆盖的时间8.7d±2.1 1d,明显晚于对照组的5.8d±2.3d,差异有统计学意义(P<0.01)。[结论]雾化吸入糖皮质激素治疗后加强口腔护理能预防、控制口腔念珠菌病。

Objective：To probe into the nursing strategies of oral candidiasis caused by inhaled corticosteroids. The elderly patients with oral candidiasis caused by inhaled corticosteroids admitted in our hospital from January 2009 to December 2010 were summarized retrospectively,all patients were divided into control group and observation group,47 cases of control group patients were given saline mouthwash after atomization inhaled corticoste- roids treatment; 50 cases of observation group used 3% sodium bicarbon- ate mouthwash after nebulized glucocorticoid treatment, then to summarize and compare the number of positive samples of oral swab culture and oral leukoplakia coverage time between two groups. Results.The oral swab cul- ture positive specimens proportion of observation group 18% was significantly lower than that 78. 7% of the control group, the oral leukoplakia coverage ratio 16% was significantly lower than that 74.4% of the control group,the differences were statistically sig nificant（P〈0. 05）. The occurrence timeo{ oral swab culture positive specimens in observation groupwas 7.7 d±2.33 d,which was significantly later than that of control group with 5. 7 d±1. 71 d, oral leukoplakia coverage time was 8.7 d±2.11 d,which was significantly later than that of control group,5.8 d±2.3d,the difference was statistically significant（P〈0.01）. Conclusion：To strengthen oral care of patients after receiving nebulized glucocorticoid treatment can prevent and control the oral candidiasis.