自拟方中药漱口液预防重症监护室中气管插管患者呼吸机相关性肺炎的研究

Study on the Prevention of Ventilator-associated Pneumonia in Patients with Endotracheal Intubation in Intensive Care Unit by the Self-made Chinese Herbal Gargle

目的:观察自拟中药漱口液对于重症监护室(ICU)经口气管插管患者的呼吸机相关性肺炎(VAP)预防效果。方法:收集2019年7月—2021年6月于ICU科室经口气管插管患者共计60例,随机分为观察组和对照组,各30例。观察组予以自拟方中药漱口液治疗;对照组予以复方氯己定含漱液漱口治疗。对比VAP发生率、并发症发生率、口臭评分和机械通气时间。结果:治疗后,观察组VAP发生率为6.67%,对照组为30.00%,差异具有统计学意义(P<0.05);不良反应方面,观察组的口腔疱疹、口腔真菌、口臭和口腔溃疡发生率分别为3.33%、3.33%、6.67%、0.00%,均低于对照组的20.00%、23.33%、26.67%、13.33%,差异有统计学意义(P<0.05)。观察组的口臭评分为(0.34±0.05)分,低于对照组的(0.95±0.09)分,差异有统计学意义(P<0.05)。观察组的机械通气时间为(12.52±1.24)d,对照组为(16.40±1.58)d,差异有统计学意义(P<0.05)。结论:使用自拟方中药漱口液可以有效预防VAP,且能减少相关并发症,缩短机械通气时间,值得临床推广。

Objective:To observe the preventive effect of self-made Chinese herbal gargle on ventilator-associated pneumonia(VAP)in patients with oral tracheal intubation in intensive care unit(ICU).Methods:A total of 60 patients with oral endotracheal intubation in ICU departments from July 2019 to June 2021 were collected and randomly divided into observation group and control group,with 30 patients in each group.The observation group was treated with a self prepared Chinese herbal gargle;The control group was treated with compound chlorhexidine gargle.The incidence of VAP,the incidence of complications,the score of halitosis and the time of mechanical ventilation were compared.Results:After treatment,the incidence of VAP was 6.67%in the observation group and 30.00%in the control group,with statistical significance(P<0.05);In terms of adverse reactions,the incidences of oral herpes,oral fungus,halitosis and oral ulcer in the observation group were 3.33%,3.33%,6.67%and 0.00%respectively,which were lower than those in the control group(20.00%,23.33%,26.67%and 13.33%,respectively),with statistical significance(P<0.05).The score of halitosis in the observation group was(0.34±0.05),lower than that in the control group(0.95±0.09),with a statistically significant difference(P<0.05).The duration of mechanical ventilation was(12.52±1.24)days in the observation group and(16.40±1.58)days in the control group,with a statistically significant difference(P<0.05).Conclusion:The use of Chinese herbal gargle can effectively prevent VAP,reduce related complications,and shorten the time of mechanical ventilation,which is worthy of clinical promotion.