重症监护室机械通气患者应用中药口腔冲洗预防呼吸机相关性肺炎的效果

Effect analysis of oral irrigation with traditional Chinese medicine on prevention of ventilator-associated pneumonia in patients with mechanical ventilation in intensive care unit

目的 分析重症监护室(ICU)机械通气患者应用中药口腔冲洗预防呼吸机相关性肺炎的效果。方法 选取2022年7月至2023年6月浙江省温州市中心医院收治的ICU机械通气患者160例为研究对象,按照随机数字表法将其分为对照组和观察组,各80例。对照组给予囊上引流,观察组给予中药口腔冲洗联合囊上引流。两组均干预1周。比较两组干预前后呼吸机相关性肺炎发生情况、血气指标[动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、pH值]、乳酸水平。结果 观察组呼吸机相关性肺炎总发生率低于对照组(P<0.05)。干预后,两组SaO_(2)、PaO_(2)、pH值水平较干预前升高,PaCO_(2)水平较干预前降低,且观察组SaO_(2)、PaO_(2)、pH值水平高于对照组,PaCO_(2)水平低于对照组(P<0.05)。干预后,两组乳酸水平较干预前降低,且观察组低于对照组(P<0.05)。结论 ICU机械通气患者应用中药口腔冲洗后口呼吸机相关性肺炎发生率降低,血气指标改善。

Objective To analyze the effect of oral irrigation with traditional Chinese medicine on prevention of ventilator-associated pneumonia in patients with mechanical ventilation in intensive care unit(ICU).Methods A total of 160 patients with mechanical ventilation in ICU admitted to Wenzhou Central Hospital in Zhejiang Province from July 2022 to June 2023 were selected as the study objects,they were divided into control group and observation group by random number table method,with 80 cases in each group.The control group was given supracapsular drainage,and the observation group was given oral irrigation with traditional Chinese medicine combined with supracapsular drainage.Both groups were treated for one week.The incidence of ventilator-associated pneumonia,blood gas index(arterial oxygen saturation[SaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)],arterial partial oxygen pressure[PaO_(2)],and pH value),and lactic acid level were compared between the two groups before and after intervention.Results The total incidence of ventilator-associated pneumonia in observation group was lower than that in control group(P<0.05).After intervention,the levels of SaO_(2),PaO_(2),and pH in the two groups were higher than those before intervention,and the level of PaCO_(2) was lower than that before intervention,and the level of SaO_(2),PaO_(2) and pH value in the observation group were higher than those in the control group,and the level of PaCO_(2) was lower than that in the control group(P<0.05).After intervention,the lactate level in both groups was lower than that before intervention,and that in the observation group was lower than that in the control group(P<0.05).Conclusion The incidence of ventilator-associated pneumonia is decreased and blood gas index is improved in ICU mechanical ventilation patients after oral irrigation with traditional Chinese medicine.