氯己定联合一次性组合吸痰管在机械通气中的应用

Application value of chlorhexidine combined with disposable combined type sputum suction tube in ventilator-associated pneumonia

目的：探讨氯己定联合一次性组合吸痰管在机械通气中的应用价值，为监护病房预防控制医院感染提供有效方法。方法104例机械通气患者按数表法随机分为观察组55例和对照组49例。患者住院期间观察两组出现口腔感染和VAP的发生率；在入院时和住院期间评价两组的临床肺部感染评分（ CPIS）。结果观察组的口腔疱疹、溃疡发生率分别为3．64％、9．09％，均低于对照组，差异均有统计学意义（χ2＝4．802、4．494，均P＜0．05）。观察组机械通气3 d后和7 d后的VAP发生率分别为3．64％、12．73％，均低于对照组，差异均有统计学意义（χ2＝5．945、4．037，均P＜0．05）。机械通气3 d后和7 d后，观察组的CPIS评分分别为（4．94±0．76）分、（5．29±0．91）分，均低于对照组，差异均有统计学意义（t＝3．812、3．295，均P＜0．05）。结论氯己定联合一次性组合吸痰管处理机械通气患者，可降低口腔感染和VAP的发生率，具有较高的临床应用价值。

Objective To explore the application value of chlorhexidine combined with disposable combined type sputum suction tube in ventilator-associated pneumonia（VAP）.To provide an effective method for prevention and control of hospital infection in ICU.Methods 104 patients with mechanical ventilation were randomly divided into the observation group（55 cases） and control group（49 cases）.During the period of hospitalization,the incidence rates of oral infection and VAP of the two groups were observed.At the time of admission and in-hospital,clinical pulmonary infection scores （CPIS） of the two groups were evaluated.Results Oral herpes,ulcer incidence rates of the observation group were 3.64%,9.09%,which were lower than the control group,the differences were statistically significant （χ2 =4.802,4.494,all P〈0.05）.After 3 days and 7 days of mechanical ventilation,VAP incidence rates of the observation group were 3.64%,12.73%,which were lower than the control group,the differences were statisti-cally significant （χ2 =5.945,4.037,all P〈0.05）.After 3 days and 7 days of mechanical ventilation,the results of CPIS of the observation group were （4.94 ±0.76） points,（5.29 ±0.91） points,which were lower than the control group,the differences were statistically significant （t=3.812,3.295,all P〈0.05）.Conclusion The medical care of chlorhexidine combined with disposable combined type sputum suction tube showes significant effect on patients with mechanical ventilation,has high value in clinical application.