冰硼合剂口腔护理预防呼吸机相关性肺炎的研究

Study on Prevention of Ventilator-Associated Pneumonia by Mouth Care with Bingpeng Mixture

目的运用冰硼合剂对比双氧水口腔护理对预防呼吸机相关性肺炎(VAP)的临床观察。方法将62例入住ICU行有创机械通气的患者随机分成两组,治疗组予自拟中药方剂冰硼合剂进行口腔护理,对照组予双氧水进行口腔护理。有创机械通气后立即进行口腔病原菌及下呼吸道病原菌检查,之后每隔3 d进行一次口腔病原菌及下呼吸道病原菌检查,每隔3 d行床边正位胸片检查。结果抗生素使用时间、VAP的发生率、低氧血症的发生率、ICU住院时间、机械通气时间5个方面对比均差异有统计学意义(P<0.05或P<0.01)。两组所有患者第1日与第10日口腔及下呼吸道分泌物培养细菌检出总数前后比较有统计学差异(P<0.05或P<0.01);两组同时期比较均无明显差异(P>0.05)。结论冰硼合剂口腔护理能更好预防VAP的发生。

Objective： To compare the preventive effect of Bingpeng Mixture with that of hydrogen peroxide on ventilator-associated pneumonia （VAP） by mouth care. Methods： 62 patients in ICU with invasive mechanical ventilation were randomly divided into two groups. The treatment group was given Bingpeng Mixture by mouth care while the control group was given hydrogen peroxide by mouth care. Oral pathogens and lower respiratory tract pathogens were examined immediately after invasive mechanical ventilation. Then, such tests repeated along with bedside chest radiograph. Results： 5 aspects including therapeutic time of antibiotics,incidence of VAP,incidence of hypoxemia, duration of mechanical ventilation, and ICU stay were statistically significant （P 〈0.05 or 0.01 ）. There were significant differences （P〈0.01 ） in treatment group at lower respiratory tract＇s bacterial colony count comparing the 1st day and the 10th day. The control group had no statistical differences （P〈0.05）. Bacterial colony count of two groups has decreased with no statistical differences （P〉0.05）. Conclusion： Bingpeng Mixture by mouth care is better to prevent VAP.