自拟蒲姜含漱液联合冲吸式口护吸痰管预防呼吸机相关性肺炎临床研究  

Clinical Study on Pujiang Gargarism Combined with Washing-suction Oral Guard Sputum Suction Tube in the Prevention of Ventilator-associated Pneumonia

作　　者：林少虹 吴宇焕 张宇[1] 邓熙[1] 刘汉娇[1] 吴凡伟[2] LIN Shaohong;WU Yuhuan;ZHANG Yu;DENG Xi;LIU Hanjiao;WU Fanwei(Department of Intensive Care Unit,Baoan District Hospital of Traditional Chinese Medicine,Guangdong Province,Shenzhen 518133,China;Genres Studio of Baoan District Hospital of Traditional Chinese Medicine,Guangdong Province,Shenzhen 518133,China)

机构地区：[1]深圳市宝安区中医院重症医学科,广东深圳518133 [2]深圳市宝安区中医院流派工作室,广东深圳518133

出　　处：《光明中医》2022年第14期2629-2633,共5页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：广东省中医药局科研项目(No.20182129);深圳市宝安区基础研究项目(No.2019JD350)。

摘　　要：目的评估自拟蒲姜含漱液联合冲吸式口护吸痰管对ICU机械通气患者口腔卫生状况及呼吸机相关性肺炎影响。方法选取2019年6月—2020年11月ICU收治的60例经口-气管插管机械通气48 h以上的患者为研究对象,将患者随机分为对照组(复方氯己定含漱液)和研究组(自拟蒲姜含漱液),每组30例。均联合冲吸式口护吸痰管进行口腔护理,以口腔卫生状况、机械通气和ICU监护时间、呼吸机相关性肺炎发生以及微生物培养结果为评价指标。结果研究组患者口腔异味评分、牙菌斑指数、牙龈肿胀、咽拭子涂片找真菌阳性率、咽拭子真菌培养阳性率以及机械通气时间均低于对照组,差异有统计学意义(P<0.05),且能减少患者VAP发生率及缩短ICU监护时间,但差异无统计学意义(P>0.05),2组均未出现不良反应。结论与复方氯己定含漱液相比,蒲姜含漱液联合冲吸式口护吸痰管对改善口腔卫生更有效,可减少机械通气时间,抑制真菌感染,有望降低呼吸机相关性肺炎发生概率。Objective To evaluate the effect of oral nursing care by Pujiang gargarism with suction toothbrush on oral hygiene and ventilatorassociated pneumonia in patients with ICU mechanical ventilation.Methods From June 2019 to November 2020,60 patients with mechanical ventilation through oral-tracheal intubation were selected as ICU subjects.The patients were randomly divided into control group(compound chlorhexidine)and study group(Pujiang gargarism),with 30 cases in each group.Using uniform care procedures,based on oral hygiene status,time of mechanical ventilation and ICU monitoring,occurrence of ventilator-associated pneumonia and results of microbial culture were monitored.Results Compared with compound chlorhexidine,the oral odour score,plaque index,and the incidence of gingival swelling and oral fungal positive rate was lower than that of control group,the average mechanical ventilation time was lower than that of control group(P<0.05),the average ICU monitoring time and VAP were not significantly different(P>0.05).Conclusion Compared with compound chlorhexidine,Pujiang gargarism with suction toothbrush is more effective in improving oral hygiene,reducing mechanical ventilation time,strongly antibacterial and antifungal also,and reducing the probability of ventilator-associated pneumonia.

关 键 词：蒲姜含漱液 口腔护理 口腔卫生状况 真菌感染 呼吸机相关性肺炎 重症监护 

分 类 号：R473.5[医药卫生—护理学]