冲吸式牙刷在AECOPD气管插管患者口腔护理中的应用

Application of flushing and suction toothbrush in AECOPD patients with tracheal intubation

目的探讨冲吸式牙刷在慢性阻塞性肺疾病急性加重(AECOPD)气管插管患者口腔护理中的应用效果。方法选取2020年8月至2021年11月在柳州市人民医院呼吸重症监护病房(RICU)接受治疗的50例AECOPD患者为研究对象,根据随机数字表分为对照组(n=25)和观察组(n=25),对照组采用口护包护理,观察组采用冲吸式牙刷护理。比较两组护理用时、护士满意度、口腔出血和呼吸机相关性肺炎(VAP)、灌洗液培养结果。结果观察组护理用时[(8.39±2.19)min]较对照组[(12.50±2.13)min]短,护士满意度评分[(27.3±3.2)分]较对照组[(20.2±5.3)分]高,口腔出血发生率[12.0%(3/25)]较对照组[36.0%(9/25)]低,组间比较差异有统计学意义(P<0.05或0.01);观察组病原菌检出率(36.0%)及VAP发生率(12.0%)均低于对照组,但比较差异无统计学意义(P>0.05)。结论与口护包相比,冲吸式牙刷能够缩短护理用时,护士满意度高,口腔并发症少,但对VAP、病原菌培养结果影响不明显。

Objective To investigate the effect of flushing and suction toothbrush in oral care of patients with tracheal intubation during acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 50 cases of AECOPD who received treatment in the Respiratory Intensive Care Unit(RICU)of Liuzhou People's Hospital from August 2020 to November 2021 were selected as study subjects.They were divided into control group(n=25)and observation group(n=25)based on random number table.The control group received oral care with a protective bag,while the observation group received oral care with flushing and suction toothbrush.And then,nursing time,nurse satisfaction,oral bleeding,ventilator-associated pneumonia(VAP),and lavage fluid culture results between the two groups were compared.Results The nursing time of the observation group([8.39±2.19]min)was shorter than that of the control group([12.50±2.13]min),the nurse satisfaction score([27.3±3.2]points)was higher than that of the control group([20.2±5.3]points),and the the incidence of oral bleeding(12.0%[3/25])was lower than that of the control group(36.0%[9/25]),and difference between groups was statistically significant(P<0.05 or 0.01).The detection rate of pathogenic bacteria(36.0%)and VAP incidence rate(12.0%)in the observation group were lower than those in the control group,but the difference was not statistically significant(P>0.05).Conclusion Compared with oral care packs,the flushing and suction toothbrush can shorten nursing time,increase nurse satisfaction,and reduce oral complications.However,its impact on VAP and pathogen culture results is not significant.