复方氯己定含漱液预防胸外科手术后肺部感染价值探讨

Application of Compound Gargle Solution Chlorhexidine Giuconatie in Prevention of Pulmonary Infection after Thoracic Operation

目的观察胸外科手术患者口咽部细菌和真菌定植情况及其与术后肺部感染的关系,并探讨复方氯己定含漱液在减少胸外科术后肺部感染中的作用。方法选取100例胸科手术后患者,入院时作咽拭子培养,然后随机分为观察组和对照组,观察组术前3 d每日用复方氯己定含漱液漱口,对照组用0.9%氯化钠注射液漱口;术晨再次作咽拭子培养,并在术后第3天作痰细菌和真菌培养。比较两组患者各个时点细菌和真菌培养的阳性率、术后肺部感染发生率。结果两组患者入院时咽拭子培养阳性率无显著差异,观察组患者术前晨咽拭子培养阳性率和术后第3天痰培养阳性率均显著低于对照组(P<0.05)。结论术前应用复方氯己定含漱液漱口可降低口咽部细菌和真菌定植率,但是否能降低术后感染率尚需进一步临床研究证实。

Objective To explore relationship between colonized bacteria and fungi in mouth-pharynx and postoperative pulmonary infection in the patients with thoracotomy and to investigate the effect of Compound Gargle Solution Chlorhexidine Giuconatie in reducing postoperative pulmonary infection in thoracotomy. Methods 100 patients undergoing thoracic surgery were performed the throat swab culture after admission and then equally divided into the observation group and the control group. The observation group rinsed the mouth before operation with Compound Gargle Solution Chlorhexidine Giuconatie for 3 d,twice a day; while the control group rinsed the mouth with 0. 9% sodium chloride injection; the throat swab culture was repeated in the operative morning, and the sputum bacterial and fungal culture was performed on postoperative 3 d. The positive rates of the bacterial and fungal culture at each time point and the occurrence rates of postoperative pulmonary infection were compared between 2 groups. Result s The positive rates of the throat swab culture on admission had no statistically significant difference between the two groups, but the positive rate of the throat swab culture on the operative morning and the positive rate of the sputum culture on postoperative 3 d in the observation group were significantly lower than those in the control group with statistical differencev（ P 0. 05）. Conclusion Rinsing mouth by Compound Gargle Solution Chlorhexidine Giuconatie could decrease the colonization rate of bacteria and fungi in mouth and the occurrence rate of postoperative pulmonary infection in the patients undergoing thoracotomy,which could be promoted in clinic.