长期卧床患者预防吸入性肺炎的护理

Nursing measures to prevent aspiration pneumonia in bed-ridden patients

目的探讨长期卧床患者预防吸入性肺炎发生的护理方法,改善吸入性肺炎患者的预后。方法将112例长期卧床患者随机分为护理对照组、常规口腔护理组及口腔护理咳嗽反射刺激组,分别按不同的方法进行护理,对3组患者中发生吸入性肺炎的例数及预后进行统计分析。结果常规口腔护理组、口腔护理咳嗽反射刺激组、对照组吸入性肺炎的发病率分别为54.00%、20.00、6.25%,组间比较差异有统计学意义(P<0.05);口腔护理咳嗽反射刺激组发生吸入性肺炎的例数低于常规口腔护理组,差异有统计学意义(P<0.05);对各护理组的预后分析发现,治愈65例,治愈率58.04%,好转27例,好转率24.11%,死亡20例,病死率17.86%;其中口腔护理咳嗽反射刺激组的治愈率显著高于其他各组,对照组的病死率最高。结论对于长期卧床患者,加强口腔护理及咳嗽反射刺激,有助于减少吸入性肺炎的发生,并可增加吸入性肺炎的治愈率。

OBJECTIVE To investigate the nursing measures to prevent aspiration pneumonia in the bed-ridden patients so as to improve the prognosis of the aspiration pneumonia patients. METHODS Totally 112 cases of bedridden patients were randomly divided into three groups： the control group, the conventional oral care group, and the oral care add cough reflex stimulation group, which were respectively given different nursing measures, then the number of the cases of aspiration pneumonia and the prognosis of the three groups were statistically analyzed. RESULTS The incidence rate of the aspiration pneumonia was 54. 00% in the conventional oral care group, 20.00% in the oral care add cough reflex stimulation group, 6.25% in the control group, the difference between the three groups was statistically significant（P〈0.05）. The number of the cases of aspiration pneumonia was less in the oral care add cough reflex stimulation group than in the conventional oral care group, the difference was statistically significant（P〈0.05）. As for the prognosis of the three groups, 65 cases were cured with the cure rate of 58.04%, 27 cases were improved with the improvement rate of 24. 11%, and 20 cases died with the mortality of 17.86%3 the cure rate of the number of the oral care add cough reflex sensitivity group was sisnifiont lower than conventional oral care group, （P〈0.05）. The clinical outcome of patients in each group found by analysis： 65 cases cured （64.7%）, 37 cases marked progress （27.2%） and 11 cases died （8.1%）. The cure rate of oral care add cough reflex stimulation group was significantly higher than that of other two groups, and the mortality was highest in the control group. CONCLUSION To enhance the oral care and cough reflex stimulation for the bedridden patients may contribute to the decrease of incidence of aspiration pneumonia and improve the cure rate.