长效抗菌材料在经口气管插管患者口腔护理中的应用研究

Application research of long-acting antibacterial material in oral cavity nursing in orotracheal intubation patients

目的：探讨长效抗菌材料对经口气管插管机械通气患者口腔护理干预效果。方法选取2013年12月1日至2014年8月31日入住徐州医学院附属医院神经外科重症监护室且经口气管插管行机械通气患者100例，按随机数字表法分为对照组和试验组，每组50例。对照组采用0.9%氯化钠进行擦洗+冲洗的口腔护理方法；试验组在对照组基础上再向口腔内喷涂长效抗菌材料。比较2组口腔异味、口腔感染、呼吸机相关性肺炎发生率等指标。结果试验组气管插管48 h，拔管时、拔管后48 h发生口腔异味、口腔感染、呼吸机相关性肺炎均低于对照组，差异有统计学意义（χ2=4.504～13.728，P<0.05）。结论长效抗菌材料能有效改善经口气管插管机械通气患者口腔卫生状况，减少口腔异味的发生，降低口腔感染及早发型呼吸机相关性肺炎发生率，值得推广使用。

Objective To explore the effectiveness of long-acting antibacterial material that was used as an intervention in oral care cavity nursing in patients with endotracheal intubation and mechanical ventilation. Methods Patients admitted to Xuzhou Medical College Hospital neurosurgery intensive care unit between 1st December 2013 and 31st August 2014 requiring intubation and mechanical ventilation were enrolled into the study. There were 100 cases randomly selected and were assigned into control group and experimental group by random number table. Each contained 50 cases. Control group used saline for oral care by brushing and irrigation;experimental group used antimicrobial material oral spray in oral care on the top of the method used in control group. The mouth odor, mouth infection rate and ventilator-associated pneumonia (VAP) rate were used to determine. Results About oral odor, mouth infection rate, and VAP rate, the difference of incidences between experimental group and the control group was significant (χ2=4.504-13.728, P <0.05). Conclusions Antimicrobial material can effectively improve oral health in intubated and mechanical ventilated patients. It slows oral acidic environment change, reduces oral infections early onset VAP incidence. And it is worth promoting its use.