ICU患者应用口腔护理液降低呼吸机相关性肺炎的临床研究

ICU patients in clinical studies of oral care solution to reduce lung infection

目的评价口腔护理液对ICU患者呼吸机相关性肺炎(VAP)的影响,以降低ICU患者VAP发生率。方法选取医院2013年1月-2015年6月收治的ICU患者共160例,随机分为对照组和试验组,每组各80例;两组患者临床资料差异均无统计学意义;两组患者均存在明显的口腔问题,其中对照组患者使用刷牙和生理盐水进行口腔护理,试验组使用刷牙和复方氯己定进行口腔护理,评价两种口腔护理方法对口腔功能以及VAP的发病率的影响。结果治疗后,试验组患者的口腔功能显著改善,其吞咽功能、舌头及舌苔、牙齿及牙龈均显著优于对照组,差异有统计学意义(P<0.05);试验组患者VAP发生率显著低于对照组,进一步的分析表明,两组患者早发型VAP和迟发型VAP构成比差异无统计学意义。结论复方氯己定口腔护理液可以显著改善患者口腔功能,并显著降低患者VAP的发生率,对于存在明显口腔问题的ICU患者,推荐使用复方氯己定护理液进行口腔护理。

OBJECTIVE To evaluate the effect of oral care solution on ICU patients with ventilator-associated pneumonia（VAP）,so as to reduce the incidence rate of VAP in ICU patients.METHODS A total of 160 cases of ICU patients admitted in our hospital from Jan.2013 to Jun.2015 were randomly divided into control group and observation group,with 80 cases in each group.There was no significant difference（P〈0.05）in two groups on clinical data.There were significant oral problems in both group of patients,the control group patients with brushing and normal saline oral care,but observation group using chlorhexidine compound brushing for oral care.The effect of two methods on oral function and incidence of VAP was evaluated.RESULTS Compared with the control group,oral function in the observation group was significantly improved.After treatment,the swallowing function in patients with the observation group,the tongue and the coating on the tongue,teeth and gums were significantly better than that in the control group（P〈0.05）.The incidence of VAP in patients in the observation group was significantly lower than that in the control group.Further analysis showed that the constituent ratio of two groups of patients early-onset and late-onset VAP had no significant difference.CONCLUSIONCompound chlorhexidine oral care solution can significantly improve oral function in ICU patients and significantly reduce the incidence of VAP,and compound chlorhexidine nursing care solution are suggested to use for oral care.