改良成人经口气管插管机械通气患者口腔护理方法及应用

Improved oral care method andits applications for adult patients with orotracheal intubation mechanical ventilation

目的探讨改良成人经口气管插管机械通气患者口腔护理方法的应用效果。方法便利抽样选取2021年1月1日至2021年12月30日四川省人民医院神外监护室经口气管插管机械通气患者220例为对照组,口腔护理方法为冲洗+擦拭+吸痰管连接负压吸引;2022年1月1日至2022年12月30日经口气管插管机械通气患者163例为观察组,口腔护理方法为擦拭+冲洗+吸唾管连接负压吸引。比较两组患者口腔异味发生率、口腔污垢残留、操作时口腔内污液溢出及吸唾管/吸痰管滑出情况、呼吸机相关性肺炎发生率。结果两组患者呼吸机相关性肺炎发生率比较差异无统计学意义(P>0.05);两组口腔异味发生率、口腔污垢残留、操作时口腔内污液溢出及吸唾管/吸痰管滑出、操作耗时等比较,差异有统计学意义(P<0.05);100%操作人员愿意选择观察组的吸唾管连接负压吸引口腔护理废液(P<0.05)。结论改良成人经口气管插管机械通气患者口腔护理方法,能提高口腔护理质量、提高患者舒适度,节约成本、提高工作效率,有一定的推广应用价值。

Objective To explore the application effect of improved oral nursing method for adult patients with oral tracheal intubation mechanical ventilation.Methods From January 1,2021 to December 30,2021,220 patients with oral tracheal intubation mechanical ventilation in our hospital were selected as a control group by using convenient sampling.The oral care method was washing+wiping+suction tube connected with negative pressure suction.From January 1,2022 to December 30,2022,163 patients with mechanical ventilation through oral tracheal intubation were selected as a test group.The oral care method was wiping+washing+saliva ejector connected with negative pressure suction.The incidence of oral odor,residual oral dirt,overflow of oral fluid during operation,and sliding out of saliva ejector/sputum suction tube as well as the incidence of ventilator-associated pneumonia were compared between the two groups.Results There was no statistically significant difference in the incidence of ventilator-associated pneumonia between the two groups.However,there were statistically significant differences in the incidence of oral odor,residual oral dirt,overflow of oral fluid during operation,and sliding out of saliva ejector/sputum suction tube between the two groups(P<0.05).100%of operators were willing to choose the saliva ejector connected to negative pressure suction for oral care waste liquid(P<0.05).Conclusions The improvement of oral care method for adult patients with oral tracheal intubation mechanical ventilation can improve the quality of oral care and patients'comfort.It saves the costs and improves the work efficiency.It has a certain promotion and application value.