母乳联合碳酸氢钠口腔护理预防新生儿呼吸机相关性肺炎的效果研究  

Study on effect of oral care using breast milk combined with sodium bicarbonate on prevention of ventilator-associated pneumonia in newborns

作　　者：李晶晶[1] 王思思 LI Jing- jing;WANG Si- si(Yangzhou Institute o f Technology, Yangzhou 225002 , China)

机构地区：[1]扬州市职业大学,225002 [2]扬州大学附属医院,100142

出　　处：《中国实用医药》2019年第29期128-129,共2页China Practical Medicine

摘　　要：目的探讨母乳联合碳酸氢钠口腔护理预防新生儿呼吸机相关性肺炎(VAP)的临床效果.方法 78例新生儿重症监护病房(NICU)需要呼吸机辅助治疗的新生儿,按入院先后顺序分为实验组(单数)和对照组(双数).实验组采用母乳联合碳酸氢钠溶液进行口腔护理,对照组采用单纯碳酸氢钠溶液进行口腔护理.比较两组VAP发生情况、口腔感染发生情况,观察两组气管内分泌物培养情况.结果对照组VAP发生率为23.1%,实验组VAP发生率为2.6%;实验组VAP发生率低于对照组,差异有统计学意义(P<0.05).对照组口腔感染发生率为15.4%,实验组口腔感染发生率为2.6%;实验组口腔感染发生率低于对照组,差异有统计学意义(P<0.05).机械通气48 h后,对照组9例VAP患儿中,3例为表皮葡萄球菌+感染,3例为尿肠球菌感染,1例为肺炎克雷伯菌感染,1例为溶血性葡萄球菌感染,1例为大肠埃希菌感染;实验组1例患儿为肺炎克雷伯菌感染.结论母乳联合碳酸氢钠进行口腔护理,可减少新生儿VAP及口腔感染情况,值得在临床推广.】 Objective To discuss the clinical effect of oral care using breast milk combined with sodium bicarbonate on prevention of ventilator-associated pneumonia(VAP) in newborns. Methods A total of 78 neonatal intensive care unit(NICU) neonates requiring ventilator-assisted therapy were divided by admission order into experimental group(singular) and control group(binary). The experimental group received oral care using breast milk combined with sodium bicarbonate, and the control group received oral care using sodium bicarbonate. The occurrence of VAP and oral infection was compared, and the culture status of endotracheal secretions was compared in the two groups. Results The incidence of VAP was 23.1% in the control group, which was 2.6 % in the experimental group. The incidence of VAP in the experimental group was lower than that in the control group, and the difference was statistically significant(P<0.05). The incidence of oral infection was 15.4% in the control group, which was 2.6% in the experimental group. The incidence of oral infection in the experimental group was lower than that in the control group, and the difference was statistically significant(P<0.05). 48 h after mechanical ventilation, 3 cases were Staphylococcus epidermidis + infection, 3 cases were Enterococcus urinae infection, 1 case was Klebsiella pneumoniae infection, 1 case was Staphylococcus hemolyticus infection, 1 case was Escherichia coli infection of 9 VAP children in the control group, and 1 case was Klebsiella pneumoniae infection in the experimental group. Conclusion Oral care using breast milk combined with sodium bicarbonate can reduce neonatal VAP and oral infection. It is worthy of clinical promotion.

关 键 词：呼吸机相关性肺炎 新生儿 母乳 碳酸氢钠 口腔护理 

分 类 号：R473.72[医药卫生—护理学]