不同口腔护理方法对呼吸机相关肺炎的影响

目的通过不同的口腔护理方法,观察其对气管插管患者呼吸机相关肺炎发生的影响。方法选取192例气管插管患者,按照住院的先后顺序,依据其口腔护理护理方式随机将患者分为对照组、观察组、实验组。对照组采用棉球擦拭的口腔护理方式;观察组采用纱布擦拭的口腔护理方式;实验组采用纱布擦拭配合冲洗的方式进行口腔护理。结果 3组患者口腔护理后菌培养数、口腔不清洁率,观察组、实验组同对照组两两比较,差异有统计学意义(P<0.05);且观察组、实验组的菌落数要少于对照组(P<0.05)。护理后对照组、观察组、实验组菌落数分别为(62.7±6.67)cfu/m L、(41.5±7.26)cfu/m L、(30.2±4.55)cfu/m L。痰培养阳性率、呼吸机相关性肺炎千日感染率及患者满意度,观察组、实验组分别与对照组比较,差异有统计学意义(P<0.05)。3组患者痰培养阳性率分别为21.43%、7.25%、7.46%。千日感染率分别为18.47‰、7.11‰、8.89‰。患者满意度分别为41.07%、79.71%、83.58%。结论通过纱布擦拭及冲洗的口腔护理方式,可有效控制口腔定植菌的数量,预防呼吸机相关肺炎的发生。

Objective Through oral care, observation of its effect on the tracheal intubation in patients with ventilator associated pneumonia occurred. Methods 192 cases of patients with tracheal intubation, according to the order of hospitalization, according to their oral care nursing methods were randomly divided into control group, group, the experimental group was observed, control group with oral care methods cotton ball wiping, observation group with oral nursing mode of gauze, the experimental group used gauze wipe and rinse way of oral nursing. Results 3 groups of patients after oral care oral bacteria, clean rate, observation group, experimental group and control group was two two, the difference was statistically significant （P〈0.05）, and the observation group, the number of colonies in experimental group than control group, and control group, the observation group, the experimental group counts respectively （62.7± 6.67） cfu/mL, （41.5±7.26） cfu/mL, （30.2±4.55） cfu/mL. Positive rate of sputum culture, ventilator-associated pneumonia 1000 day infection rate and patient satisfaction of the observation group, the experimental group were compared with the control group, the difference was statistically significant （P〈0.05）. Three groups of patients with sputum culture positive rates were 21.43%, 7.25%, 7.46%. on the infection rate of 18.47 per thousand, 7.11 per thousand, 8.89 per thousand. The satisfaction of patients were 41.07%, 79.71%, 83.58%. Conclusion The oral nursing methods gauze wipe and rinse, can effectively control the number of oral bacteria colonization, the prevention of ventilator associated pneumonia.