改良口腔护理对降低肺癌术后呼吸机相关性肺炎的效果分析

Analysis of the effects of improved oral care to reduce ventilator associated pneumonia after lung cancer surgery

目的探究改良口腔护理对降低肺癌术后呼吸机相关性肺炎(ventilator associated pneumonia,VAP)的效果。方法选取2017年2月至2019年8月重庆市巴南区人民医院收治的126例肺癌患者为研究对象,根据随机原则将其分为对照组和观察组,每组各63例。对照组患者采取常规口腔护理,观察组患者采用改良口腔护理,比较两组患者痰培养情况、口腔卫生状况、口腔微生物数量、机械通气时间、住院时间及VAP发生率。结果观察组患者痰培养中正常菌群比例显著高于对照组(均P<0.05),G^+菌、G^-菌及真菌孢子菌丝比例均显著低于对照组(均P<0.05);护理1周后,观察组患者口腔异味和口腔溃疡的发生率均显著低于对照组(P<0.05)。两组患者牙龈肿胀发生率均下降,但两者比较差异无统计学意义(P>0.05);术后插管的第1、3、7天,观察组患者口腔微生物数量均显著低于同期对照组(均P<0.05);对照组患者住院时间、机械通气时间均显著长于观察组(均P<0.05),对照组患者VAP发生率显著高于观察组(P<0.05)。结论改良的口腔护理能改善患者口腔卫生情况,减少口腔溃疡和口腔异味的发生,降低VAP发生率,缩短住院时间和机械通气时间,值得推广应用。

Objective To explore the effects of improved oral care on reducing ventilator associated pneumonia after lung cancer surgery.Method One hundred and twenty six patients with lung cancer in People's Hospital of Chongqing Banan District from February 2017 to August 2019 were selected as research subjects,according to the principle of randomization,they are divided into control group and observation group,each group has 63 patients.The control group took routine oral care,and the observation group accepted modified oral care.The sputum culture status,oral hygiene status,oral microbial count,mechanical ventilation time,hospitalization time and the incidence of VAP were compared between the two groups.Result The proportion of normal flora in the sputum culture of the observation group was significantly higher than that of the control group(P<0.05);the proportion of G^+ bacteria,G^-bacteria and fungal spore hyphae in the obser vation group were significantly lower than those in the control group(all P<0.05);after 1 week of care,the incidence of oral odor and oral ulcers in the observation group were significantly lower than those in the control group(all P<0.05).The incidence of gum swelling decreased in both groups,but there was no significantly difference(P>0.05);on the 1st,3rd,7th day after intubation,the number of oral microorganisms in the observation group were significantly lower than those in the control group(all P<0.05);the hospitalization time and mechanical ventilation time of the control group were significantly longer than those of the observation group(all P<0.05),the incidence of VAP in the control group was significantly higher than that of the observation group(all P<0.05).Conclusion Improving oral care can improve the oral hygiene of patients and reduce the incidence of oral odor,oral ulcers and VAP,shorten hospitalization time and mechanical ventilation time,which is worthy of popularization and application.