Chlorhexidine溶液用於口腔護理在預防呼吸機相關性肺炎中作用的文獻複習

Effectiveness of oral care with Chlorhexidine in prevention of Ventilator-associated

目的改善重症病人口腔護理的方法,提高呼吸機相關性肺炎(VAP)的預防成效,以提高預防院內感染性肺炎的成效。方法通過文獻回顧,探討Chlorhexidine用於重症病人口腔護理對减少口腔內細菌定植及預防VAP的作用,從而找出口腔護理的最佳方法,在科室內實施相關的改革,並對改革成效行總結。結果實施改革後,2011年3月~10月痰培養有菌生長率較2010年下降18.3%。結論Chlorhexidine用於口腔護理具有良好的殺菌效果,而且不容易產生耐藥菌株,是一種成本較低、操作簡便、容易使用的方法,相對於VAP的高昂代價,具有淺而易見的成本效益。

Objective To refine the oral care intervention in the critical care unit and improve the VAP preven-tion effectiveness.If the result of the method is better than before,we would suggest experimental application in the whole healthcare setting in order to reduce the rate of nosocomial pneumonia which related to oral cavity bacteria colonization.Methods Through literatures review,we found out that chlorhexidine solution can significantly reduce bacteria colonization in oral cavity and prevent VAP incidence,and we refined the intervention of oral care.Results from March 2011 to October,the rate of positive sputum cultures decreased by 18.3%.Conclusion Chlorhexidine is an effective bactericidal agent,and it is easy and effective to apply in oral care in the critical care unit.Compares to the costly VAP,oral care with Chlorhexidine for critical care patients is more cost-effective.