ICU气管插管患者应用电动牙刷预防口腔感染的研究

Application of electric toothbrush in the prevention of oral infection in ICU patients with tracheal intubation

目的探讨电动牙刷对重症监护病房(ICU)气管插管患者预防口腔感染的效果,以减少口腔感染率。方法选择2012年6月-2014年12月于医院ICU经口气管插管患者398例,按照患者个人意愿分为观察组和对照组,每组199例,对照组采用常规口腔干预,观察组采用电动牙刷刷洗进行干预,两组患者均连续干预7d,检测患者口腔细菌阳性率,观察患者口腔异味和口腔残留物次数,黏膜损伤发生率和口腔感染率及牙菌斑平均指数。结果观察组患者7d干预中口腔细菌阳性率为2.01%、口腔异味139次占4.99%、无口腔残留物,对照组患者干预中口腔细菌阳性率为35.00%、口腔异味1 356次占48.67%、口腔残留物418次占15.00%,观察组患者各项数据均低于对照组,差异有统计学意义(P<0.01);观察组口腔黏膜损伤率为1.01%,低于对照组13.06%,差异有统计学意义(P<0.05);观察组无口腔感染,对照组口腔感染率为3.52%,差异有统计学意义(P<0.05);干预前两组患者牙菌斑平均指数比较,差异无统计学意义,干预后观察组牙菌斑平均指数与对照组比较差异有统计学意义(P<0.01),且低于对照组。结论电动牙刷刷牙可明显降低患者口腔细菌阳性率、减少口腔异味和口腔残留物,能有效去除牙菌斑。

OBJECTIVE To investigate the effect of electric toothbrush on the prevention and control of oral infec- tion in ICU patients with tracheal intubation, so as to reduce the incidence of oral infections. METHODS A total of 398 cases of patients with tracheal intubation from Jun. 2012 to Dec. 2014 in ICU of our hospital were selected, and divided into observation group and control group, according to the random number table method, with 199 ca- ses in each group. Patients in control group were received conventional oral intervention operation, and patients in observation group were received electric toothbrush brushing intervention operation. The two groups were received continuous nursing for 7 days, and the oral bacteria positive rate, the number of oral odor and oral residue, the in- cidence of oral infections and nursing and dental plaque index were detected. RESULTS In 7- day intervention of observation group, the oral bacteria positive rate was 2.01%, oral odor was 139 times, accounting for 4.99%, and oral residue was 0 time. In control group, the positive rate of oral bacteria was 35%, oral odor was 1356 times, accounting for 48.67 %, and oral residues were 418 times, accounting for 15 %. The indexes of observation group were significantly lower than those of control group （P〈0.01）. In observation group, the oral mucosal in- jury rate was 1.01%, significantly lower than 13.06 % of control group（P〈0.05）. There was no oral infection in observation group, and the infection rate of control group was 3.52%, the difference was signifieant（P〈 0.05）. The dental plaque index had no significant difference between the two groups before intervention. After nursing in- tervention, the average dental plaque index of patients of observation group was significantly lower than that of control group（P（0.01）. CONCLUSION Electric toothbrush can significantly reduce the positive rate of oral bacte- ria, mouth odor and oral residues, effectively remove dental plaque and reduce oral mucosa injury rate and oral in- fection rate.