过氧化氢在经口气管插管患者口腔护理中的应用  

Application of hydrogen peroxide in nursing care for the oral cavities of the patients with orotracheal intubation

作　　者：刘春香[1] 祝立阳[2] 莫伟梅[2] 林琦[2] 韦涌初[2] 黎冬梅[3] 朱旭[3] 

机构地区：[1]广西医科大学第三附属医院感染性疾病科,南宁530031 [2]广西医科大学第三附属医院心胸外科,南宁530031 [3]广西医科大学第三附属医院检验科,南宁530031

出　　处：《中华现代护理杂志》2013年第28期3540-3542,共3页Chinese Journal of Modern Nursing

基　　金：南宁市科学研究与技术开发计划项目（ZC200809C）

摘　　要：目的 探讨过氧化氢对经口气管插管患者预防感染性并发症的效果.方法 将90例经口气管插管机械通气患者随机分为A、B、C三组,每组各30例.A组患者采用3％过氧化氢溶液棉球擦洗联合0.9％氯化钠溶液冲洗口腔；B组采用0.9％氯化钠溶液冲洗口腔；C组按常规采用0.9％氯化钠溶液棉球进行口腔擦洗,均每日2次.观察三组患者口咽部细菌数、口腔pH值和清洁度及口腔感染的发生率.结果 三种方法护理口腔后,A、B、C三组口咽部细菌数均减少[分别为（306.70±15.57）,（436.10±19.14）,（762.33±28.46） cfu/平皿；F=116.5；P＜0.05],以A组最明显；三组方法护理后患者口腔pH值均升高[（6.70 ±0.085）,（6.41 ±0.102）,（6.35±0.076）],三组比较差异有统计学意义（F=4.415；P＜0.05）,且以A组升高最明显；三组患者牙菌斑发生率（16.67％,40.00％,33.33％）及口腔感染发生率（10.00％,20.00％,33.33％）比较,差异无统计学意义（x2值分别为4.127,4.937；P＞0.05）,三组患者口臭的发生率以A组最低（20.00％,43.33％,56.67％）,三组比较差异有统计学意义（x2=8.61,P＜0.05）.结论 应用3％过氧化氢溶液棉球擦洗联合0.9％氯化钠溶液冲洗经口气管插管患者口腔预防感染性并发症效果较好.Objective To explore the effect of hydrogen peroxide on the prevention of the infectious complication in the patients with orotracheal intubation.Methods Ninety patients with orotracheal intubation for mechanical ventilation were randomly divided into three groups,each with 30 cases.The oral cavities of the patients in Group A were washed with cotton balls soaked by 3％ hydrogen peroxide solution and rinsed with normal saline （0.9％ sodium chloride solution） ;those of the patients in Group B were rinsed with normal saline alone;and those of the patients in Group C were washed conventionally with cotton balls soaked by normal saline.The oral care was conducted twice daily in each group.The bacterial number in pharyngo-oral cavities,the pH values,clean degrees of oral cavities and the incidence of oral cavity infection in the three groups were observed.Results After oral care with the three methods,the bacterial number in pharyngo-oral cavities of the patients in Groups A,B and C were decreased,and respectively （306.70 ± 15.57）,（436.10 ± 19.14）,（762.33 ± 28.46） cfu/plate,the difference was statistically significant （F =116.5,P ＜ 0.05）,and the decrease in bacterial number was most significant in Group A.The oral pH values of all the patients were increased,and were respectively （6.70 ± 0.085）,（6.41 ± 0.102）,（6.35 ± 0.076） in three groups,the difference was statistically significant （F=4.415,P＜0.05）,and those of the patients in Group A were found to increase most significantly.The incidence of dental plaques （16.67％,40.00％,33.33％） and that of oral cavity infection （10.00％,20.00％,33.33％） did not show statistical significance （x2 =4.127,4.937,respectively; P ＞0.05）.The incidence of halitosis （20.00％,43.33 ％,56.67％） showed significant differences （x2 =8.61,P ＜0.05）,and the incidence of halitosis was lowest in Group A.Conclusions Washing the oral cavities with cotton balls soaked by 3％ hydrogen peroxide solution and rinsing the or

关 键 词：过氧化氢溶液 插管法 气管内 口腔护理 口咽部细菌数 

分 类 号：R472[医药卫生—护理学]