组合吸痰管结合洗必泰口腔冲洗对预防呼吸机相关肺炎的临床研究

Control value of combined suction tube combined with chlorhexidine in nosocomial infections in ventilator-associated pneumonia patients

目的探究组合吸痰管结合洗必泰对ICU应用呼吸机患者医院感染的防控价值。方法选择2014年10月-2016年10月医院ICU应用呼吸机住院患者98例,随机分为对照组和试验组,各49例;对照组给予常规棉球擦拭处理,试验组给予组合式吸痰管结合洗必泰处理,评价两组患者的口腔评分(OAG)、口腔干预效果及肺部感染评分(CPIS)等。结果治疗后,对照组的OAG评分(18.73±7.96)高于试验组(15.34±5.28)(P<0.05);试验组发生轻度口腔异味者、2级以上口腔异味者及口腔残留物检出率,口腔阳性菌检出、牙菌斑指数及口腔黏膜损伤指标均低于对照组(P<0.05);对照组CPIS评分显著低于试验组(P<0.05);对照组的血液学指标高于试验组(P<0.05)。结论组合吸痰管结合洗必泰对ICU应用呼吸机患者医院感染具有一定的防控价值,能够降低住院患者口腔细菌感染率、肺部感染率,合理提高口腔黏膜的防御能力,降低住院时间,一定程度上提高患者的生活质量。

OBJECTIVE To explore the prevention and control value of combined suction tube combined with chlorhexidine in nosocomial infections in ventilator-associated pneumonia patients in ICU.METHODS A total of 98 ICU inpatients with ventilator were enrolled from Oct.2014 to Oct.2016,and were randomly divided into control group and experimental group,with 49 cases in each group.The patients in control group were treated with oral cotton ball wipe for oral intervention,and in experimental group were treated with combined aspiration tube and chlorhexidine for oral intervention.The oral score（OAG）,oral intervention and pulmonary infection score（CPIS）were evaluated.RESULTS After treatment,the OAG score of control group（18.73±7.96）was significantly higher than that of experimental group（15.34±5.28）（P〈0.05）.The number of mild oral odor,and oral odor over grade 2,oral residue detection rate,dental plaque index and oral mucosal injury index of experimental group were all lower than those of control group（P〈0.05）.The CPIS score of control group was significantly lower than that of experimental group（P〈0.05）,and the hematological parameters of control group were higher than those in experimental group（P〈0.05）.CONCLUSION Combination of suction tube combined with chlorhexidine has a certain prevention and control value in nosocomial infections of ICU patients with ventilator.It can reduce the infection rate of oral bacteria and the rate of pulmonary infections in hospitalized patients,improve the defense ability of oral mucosa,reduce hospitalization time,and improve the quality of life of patients to a certain extent.