改良口腔干预方案对脑卒中患者肺部感染的预防评价  

Value of modified intervention to oral care in prevention of pulmonary infections in stroke patients

作　　者：王洁[1] 杨钰[1] 路海娟[1] 郑莹莹[1] 吕红叶 

机构地区：[1]南阳市中心医院神经内科,河南南阳473000

出　　处：《中华医院感染学杂志》2015年第18期4197-4199,共3页Chinese Journal of Nosocomiology

基　　金：河南省杰出人才创新基金资助项目(0621002500)

摘　　要：目的探讨改良口腔干预方案对脑卒中患者肺部感染的预防控制价值,以降低口咽部细菌定植,减少脑卒中相关性肺部感染的发生。方法选取医院2013年1月-2015年6月收治的脑卒中患者120例,将其随机分为观察组和对照组,每组60例;对照组采用常规口腔干预方法干预,观察组在此基础上,采用无菌纱布环形擦拭咽喉部;干预7d后,对比分析两组口腔气味、牙龈指数、咽拭子细菌培养和肺部感染率;采用SPSS 20.0软件对数据进行统计分析。结果干预7d后,观察组和对照组口臭有效率分别为90.00%和66.67%,两组比较差异有统计学意义(P<0.05);干预前,两组牙龈指数差异无统计学意义;干预后,观察组牙龈指数显著低于对照组(P<0.05);观察组和对照组脑卒中相关性肺部感染发生率分别为11.67%和31.67%,两组比较差异有统计学意义(P<0.05);观察组咽拭子培养阳性20例,阳性检出率为33.33%,其中革兰阴性菌12株、革兰阳性菌6株、真菌2株,分别占60.00%、30.00%和10.00%;对照组咽拭子培养阳性36例,阳性检出率为60.00%,其中革兰阴性菌26株、革兰阳性菌8株、真菌2株,分别占72.22%、22.22%和5.56%,两组差异有统计学意义(P<0.05)。结论改良口腔干预方法可显著改善脑卒中患者口腔卫生,降低脑卒中相关性肺部感染的发生率,值得临床推广应用。OBJECTIVE To explore the value of the modified intervention to oral care in prevention of pulmonary infections in the stroke patients so as to reduce the incidence of oropharyngeal bacterial colonization and prevent the stroke-associated pulmonary infections.METHODS A total of 120 stroke patients who were treated in the hospital from Jan 2013 to Jun 2015 were enrolled in the study and randomly divided into the observation group and the control group,with 60 cases each.The control group was treated with conventional interventions to oral care,while the observation group was given additional wiping the throat with annular sterile gauze based on the control group.The breath,gingival index,bacterial culture of throat swab,and incidence of pulmonary infections were observed and compared after the interventions for 7days.The statistical analysis of data was performed with the use of SPSS20.0software.RESULTS After the intervention for 7days,the effective rate of halitosis was 90.00%in the observation group,66.67%in the control group,with significant difference（P〈0.05）.There was no significant difference in the gingival index between the two groups before the intervention;the gingival index of the observation group was significantly lower than that of the control group after the intervention（P〈0.05）.The incidence of stroke-associated pulmonary infections was 11.67%in the observation group,31.67%in the control group,with significant difference（P〈0.05）.The throat swab specimens were cultured positive in 20 cases of the observation group,with the positive rate of 33.33%,and there were 12（60.00%）strains of gram-negative bacteria,6（30.00%）strains of gram-positive bacteria,and 2（10.00%）strains of fungi;the throat swab specimens were cultured positive in 36 cases of the control group,with the positive rate of 60.00%,and there were 26（72.22%）strains of gram-negative bacteria,8（22.22%）strains of gram-positive bacteria,and 2（5.56%）strains of fungi,with significant difference between the tw

关 键 词：脑卒中 肺部感染 口腔 干预 改良 

分 类 号：R563.1[医药卫生—呼吸系统]