氯己定擦浴降低神经外科ICU患者呼吸机相关肺炎的效果评价

Effect of chlorhexidine bathing on reducing ventilator-associated pneumonia in patients in neurosurgical intensive care unit

目的评价氯己定擦浴降低呼吸机相关肺炎(VAP)的效果。方法对某院神经外科重症监护病房(ICU)机械通气>48 h患者进行干预,采用氯己定皮肤擦浴,1次/日,并建立有效监督管理机制,比较干预前(2013年1—12月)和干预后(第1阶段:2014年1—12月;第2阶段:2015年1—12月)VAP发生率。结果共调查1 015例患者,干预前氯己定皮肤擦浴执行率为0,干预后第1、2阶段分别为55.36%和88.49%;干预前VAP日发生率为9.21‰,干预后第1、2阶段分别为7.67‰、4.77‰,两组数据相关分析结果显示,VAP日发生率与干预措施执行率呈负相关关系(rs=-1.00,P<0.001)。结论氯己定擦浴可以有效降低VAP发生率。

Objective To evaluate the effect of chlorhexidine bathing on reducing ventilator-associated pneumonia(VAP).Methods Patients with mechanical ventilation for>48 hours in the neurosurgical intensive care unit(ICU)in a hospital were intervened,chlorhexidine skin rubbing was performed once a day,effective supervision and management mechanism was established,incidence of VAP before intervention(January-December,2013)and after intervention(first stage:January-December,2014;second stage:January-December,2015)was compared.Results A total of 1 015 patients were investigated,implementation rate of chlorhexidine skin rubbing before intervention was 0,the first and second stages of post-intervention were 55.36%and 88.49%respectively.Incidence of VAP per 1 000 ventilator days before intervention was 9.21‰,the first and second stage after intervention were 7.67‰and 4.77‰respectively,correlation analysis on two groups of data showed that there was a negative correlation between incidence of VAP and implementation rate of intervention measures(r s=-1.00,P<0.001).Conclusion Daily bathing with chlorhexidine can effectively reduce the incidence of VAP.