探究不同药液对重症患者口腔护理的影响

Exploration on the Influence of Different Pharmaceutical Solutions on Oral Care of Critically Ill Patients

目的进行基于《成人重症监护病房口腔护理专家共识》规范操作基础上,探究更适用于中医医院危重患者的口腔护理液。方法2023年3月1日至5月31日,在某院重症医学科住院的60位老年患者,按照患者入科顺序随机将患者分为三组每组20人,中药液组:中药液配方完成标准口腔护理;生理盐水组组:使用0.9%无菌生理盐水完成标准口腔护理;洗必泰组:使用医院提供的0.1%洗必泰溶液完成标准口腔护理。记录患者刚入科第1次口腔评估、第1天、第3天、第5天及第10天分别进行Beck评分及刚入科第1次评估,第5天及第10天分别进行临床肺部感染评分。结果中药液组患者第1天口腔护理评分(11.70±1.78)分,显著低于洗必泰组患者得分(12.7±1.49)分,低于生理盐水组(13.85±1.31)分;中药液组患者第3天口腔护理评分(8.50±1.00)分,显著低于洗必泰组(10.8±1.105)分,低于生理盐水组(11.45±0.99)分;中药液组第5天口腔护理评分(6.30±9.23)分,显著低于洗必泰组(7.85±0.745)分,低于生理盐水组(8.75±0.851)分;中药液组第10天口腔护理评分(5.05±0.224)分,显著低于洗必泰组(5.25±0.444)分,低于生理盐水组(6.75±0.79)分。三组患者临床肺部感染评分第5天中药液组患者第五天得分(4.65±0.875)分,显著低于洗必泰组(6.85±1.09)分,低于生理盐水组(7.9±1.62)分;中药液组第10天得分(3.4±0.754)分,低于洗必泰组(4.15±0.745)分,低于生理盐水组(4.15±0.745)分。结论中药液对比0.1%洗必泰溶液和0.9%无菌生理盐水有更好的清洁效果,0.1%洗必泰溶液相对于0.9%生理盐水有更好的清洁效果。每组患者进行口腔护理后Beck口腔评分及临床肺部感染评分均有明显改变。

Objective To explore the more suitable oral care solutions for critically ill patients in Traditional Chinese Medicine hospitals on the basis of the standard operation of"Consensus of oral care experts in Adult intensive Care Unit".Methods From March 1st to May 31st,2023,patients hospitalized in a hospital were randomly divided into three groups,Chinese medicine liquid group:Chinese medicine liquid formula to complete standard oral care;Normal saline group:0.9%sterile normal saline was used to complete standard oral care;Chlorhexidine group:Standard oral care is completed with 0.1%chlorhexidine solution provided by the hospital.Beck score and CPIS score were recorded at the first oral assessment after admission,one day after admission,three days after admission,five days after admission,and ten days after admission,respectively.Results There was no significant difference in the score of the first admission among the three groups.The first day,the third day,the fifth day and the tenth day were statistically significant.The BECK scores of the normal saline group and the chlorhexidine group were statistically different from the fifth day,and the BECK scores of the normal saline group and the Chinese medicinal solution group were significantly different from the first day.The BECK score of chlorhexidine group and Chinese medicine liquid group was significantly different from the third day,and reached good oral condition by the tenth day.There were significant differences between the normal saline group and the chlorhexidine group from CPIS to the tenth day,the normal saline group and the Chinese herbal solution group from the fifth day of CPIS,and the chlorhexidine group and the Chinese herbal solution group from the fifth day of CPIS.The scores of patients before and after oral care in each group were statistically significant.Conclusions Compared with 0.1%chlorhexidine solution and 0.9%sterile normal saline,0.1%chlorhexidine solution had better cleaning effect than 0.9%normal saline,and Beck oral score and clinical pulmonary infection score were significantly changed after oral care in each group.