洗必泰溶液口腔护理预防呼吸机相关性肺炎的荟萃分析

Oral care with chlorhexidine for prevention of ventilator associated pneumonia:a meta analysis

目的：采用荟萃分析的方法探讨洗必泰溶液进行口腔护理预防呼吸机相关性肺炎的效果.方法：按照制订好的检索策略对国内外文献进行检索,将洗必泰溶液口腔护理对VAP发生率影响的研究结果逐个进行严格评价,采用Cochrane协作网提供的RevMan 4.2软件包进行统计分析（Meta分析）,再进行定量总和,得出综合结论.结果：采用检索词检索最终纳入9篇文献,共1 892例,观察组采用洗必泰溶液进行口腔护理931例,对照组采用安慰剂或碳酸氢钠、酚醛树脂混合物、0.01％高锰酸钾等溶液进行口腔护理共961例.观察组8.49％（79/931）的患者发生VAP,对照组12.28％（118/961）的患者发生VAP,其OR值为0.62（95％CI0.45～0.84）,表明洗必泰溶液口腔护理能降低VAP的发生率,P＜0.05.结论：采用洗必泰溶液进行口腔护理对降低VAP发生率具有良好的效果.

Objective： To explore the efficacy of Oral care with ehlorhexidine for prevention of ventilator associated pneumonia （VAP）. Methods： We searched domestic and international literature, followed by assessing the effect of the chlorhexidine solution on the VAP incidence in a rigorous way one by one. After meta-analysis provided by the Cochrane Collaboration＇s RevMan 4.2 software package, we summed and drew conclusions. Results： 9 literatures and a total of 1892 patients were adopted in the study. 931 patients in the observation group were treated by chlorhexidine solution, while 961 patients in the control group were used placebo, NaHCO3 or phenolic mixture or 0.01% KMNO4 solution. The results showed that VAP in observation group was 8.49% （79/931）, and was 12.28% （118/961） in the other group. Conclusion： Chlorhexidine solution for oral care has a good effect on reducing the incidence of VAP.