改良口腔护理方法在机械通气患者中的应用

Application of Improved Oral Nursing Method in Patients with Mechanical Ventilation

目的:探讨机械通气患者中应用改良口腔护理的效果,为临床干预提供参考。方法:回顾性分析2019年8月—2020年8月驻马店市中心医院收治的100例行机械通气的患者临床资料,将2019年8月—2020年2月采用常规口腔护理的50例患者纳入对照组,将2020年3月—2020年8月采用改良口腔护理的50例患者纳入研究组。比较护理7 d后的口腔情况[改良Beck口腔评估法(Beck)评分情况],口腔痰液微生物情况与呼吸机相关性肺炎(VAP)情况。结果:护理7 d后,两组患者Beck评分均低于护理前,且研究组低于对照组,差异有统计学意义(t=37.571,P<0.05)。研究组口腔痰液原菌检出数少于对照组,差异有统计学意义(χ^(2)=14.586,P<0.05)。研究组VAP发生率低于对照组,差异有统计学意义(χ^(2)=4.396,P<0.05)。结论:机械通气患者采用改良口腔护理可改善口腔卫生,减少病原菌的定植并降低VAP发生率,值得临床推广应用。

Objective:To explore the effect of improved oral nursing in the application of patients with mechanical ventilation,to provide reference for clinical intervention.Methods:The clinical data of 100 patients with mechanical ventilation treated in the hospital from August 2019 to August 2020 were retrospectively analyzed,the clinical data of 50 patients who received routine oral nursing from August 2019 to February 2020 were included in the control group,the clinical data of 50 patients with improved oral care from March 2020 to August 2020 were included in the study group.The oral condition(modified Beck oral assessment method[Beck]),oral sputum microbial status and ventilator-associated pneumonia(VAP)were compared after 7 d of nursing.Results:After 7 d of nursing,the Beck scores of both groups were lower than those before nursing,and the study group was lower than the control group,with statistically significant difference(t=37.571,P<0.05).The number of oral sputum protobacteria in the study group was less than that in the control group,with statistically significant difference(χ^(2)=14.586,P<0.05).The incidence of VAP in the study group was lower than that in the control group,with statistically significant difference(χ^(2)=4.396,P<0.05).Conclusion:The improved oral nursing can improve the cavity hygiene,reduce the colonization of pathogens and reduce the incidence of VAP,which is worthy of clinical application and promotion.