经口气管插管患者醋酸氯己定溶液冲洗式口腔护理的临床效果研究

The effect of chlorhexidine acetate flushing oral care in patients with endotracheal intubation

目的研究经口气管插管患者醋酸氯己定溶液冲洗式口腔护理的临床效果。方法将2017年2-8月160例经口气管插管患者按照随机数字表法分为观察组与对照组各80例。观察组采用醋酸氯己定溶液冲洗式口腔护理，对照组采用复方硼砂溶液擦洗式口腔护理。观察比较2组口腔护理后第3天患者口腔状况评分、口腔细菌培养阳性率、呼吸机相关性肺炎发生率和发生时间。结果观察组口腔护理后第3天患者口腔状况评分、口腔细菌培养阳性率分别为（10.29 ± 2.04）分、16.25%（13/80），对照组分别为（12.79 ± 1.97）分、31.25%（25/80），2组比较差异有统计学意义（t=-7.895，χ2=4.970，P〈0.01或0.05）。观察组患者呼吸机相关性肺炎发生率和发生时间分别为7.50%（6/80）、（9.33 ± 1.37）d，对照组分别为18.75%（15/80）、（5.87 ± 1.06）d，2组比较差异有统计学意义（χ2=4.440，t=6.248，P〈0.05或0.01）。结论经口气管插管患者采用醋酸氯己定冲洗式口腔护理可以显著改善口腔状况，降低口腔细菌培养阳性率及呼吸机相关性肺炎发生率，延长呼吸机相关性肺炎发生时间。

ObjectiveTo study the clinical effect of chlorhexidine acetate solution for oral care in patients with endotracheal intubation.MethodsFrom February 2017 to August 2017, 160 patients with tracheal intubation in our department were divided into the observation group （80 cases） and the control group （80 cases） by random number table method. The observation group was treated with chlorhexidine acetate solution, and the control group used the compound Borax solution for oral care. The oral condition score, the positive rate of oral bacterial culture, the incidence rate of ventilator-associated pneumonia were compared between two groups.ResultsIn the observation group, the oral condition score and the positive rate of oral bacterial culture were 10.29±2.04 and 16.25% （13/80） on the 3rd day after theoral care. In the control group, the oral condition score and the positive rate of oral bacterial culture were 12.79±1.97 and 31.25%（25/80） on the 3rd day after the oral care. There were statistically significant differences between the two groups （t=-7.895, P〈0.01; χ2=4.970, P〈0.05）. The incidence and occurrence time of ventilator-associated pneumonia in the observation group were 7.50% （6/80）, （9.33±1.37） d. The incidence and occurrence time of ventilator-associated pneumonia in the control group were 18.75% （15/80）, （5.87±1.06） d. The difference between the two groups was statistically significant （χ2= 4.440, P〈0.05; t=6.248, P〈0.01）.ConclusionsThe chlorhexidine acetate flushing oral care can significantly improve dental status, reduce the positive rate of oral bacterial culture and the incidence of ventilator-associated pneumonia, and prolong the occurrence time of ventilator-associated pneumonia in patients with endotracheal intubation.