用消毒剂调整口咽部细菌定植对呼吸机相关肺炎发生的影响

STUDY OF THE EFFECT OF ORAL DECONTAMINATION WITH CHLORHEXIDINE ON VAP INCIDENCE

目的研究消毒剂对口腔脱污染效果及其对呼吸机相关肺炎发生的影响。方法用氯己定水溶液擦拭机械通气患者口腔黏膜,通过检测病人口腔定植菌和观察呼吸机相关肺炎(VAP)发生情况进行综合评价。结果实验组病人用浓度为20 g/L的醋酸氯己定水溶液沾湿棉球擦拭口腔黏膜,每日4次,VAP发生率为25.3%,革兰阴性菌占口腔定植菌的75%。对照组病人用无菌生理盐水擦拭口腔黏膜,每日4次,VAP发生率为38.8%,革兰阴性菌占口腔定植菌的86.79%。结果机械通气病人用氯己定溶液擦拭口腔黏膜,可以改变口腔定植菌群,延迟病人VAP发生时间和降低VAP的发生率。

Objective To explore the effect of oral decontamination with Chlorhexidine on Ventilator - Associated Pneu- monia （VAP）. Methods Patients was treated with oral decontamination with Chlorhexidine solution, in order to evaluate its effects by testing oral bacteria colonization and observing the incidence of VAP. Results The experiment group was treated with oral decontamination with 20g/L Chlorhexidine solution for 4 times a day. The incidence of VAP was 25.3% and the G- bacteria accounted for 75% of all oral bacteria colonization; while the control group was treated with oral de- contamination with sterile saline for 4 times a day. The incidence of VAP was 38.8%, and the G - bacteria accounted for 86. 79% of all oral bacteria colonization. Conclusion Oral decontamination with chlorhexidine can change oral bacteria colonization, delay the onset of VAP and reduce the incidence of VAP.