ICOCFAS在神经内科ICU气管插管机械通气患者口腔干预中的应用效果  

Application effect of ICOCFAS in oral care of patients with mechanical ventilation by tracheal intubation in ICU of neurology department

作　　者：张扬 蒋丽丽[1] 王续颖 丁梦霞 蔡振媛 ZHANG Yang;JIANG Lili;WANG Xuying;DING Mengxia;CAI Zhenyuan(Department of Neurology,Huai'an First Hospital Affiliated to Nanjing Medical University,Huai'an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院神经内科,江苏淮安223300

出　　处：《现代医学》2024年第11期1780-1788,共9页Modern Medical Journal

摘　　要：目的:探讨神经内科重症监护病房(ICU)气管插管机械通气患者应用重症监护口腔护理频率评估量表(ICOCFAS)口腔护理的效果。方法:选取108例自2022年6月至2023年12月在南京医科大学附属淮安第一医院神经内科治疗的ICU气管插管机械通气患者,以随机数字表法分对照组(n=54)行常规口腔护理,研究组(n=54)在对照组基础上行ICOCFAS评分口腔护理,比较护理前,护理3 d、5 d后口腔情况;牙菌斑指数、软垢指数;呼吸机相关性肺炎(VAP)发生率及机械通气时间、神经内科ICU住院时间。结果:护理前,两组口腔健康状况评分(2.39±0.60分vs 2.45±0.53分)、口腔异味评分(2.64±0.25分vs2.60±0.29分)比较(P>0.05);护理3 d、5 d后,研究组口腔健康情况评分(1.68±0.27)分、(1.29±0.19)分,口腔异味评分(1.63±0.22)分、(1.19±0.13)分低于对照组口腔健康情况评分(2.00±0.32)分、(1.44±0.25)分,口腔异味评分(1.78±0.27)分、(1.27±0.20)分(P<0.05);经重复测量方差分析,两组口腔健康状况、口腔异味在护理前、护理3 d、5 d F_(时间)、F_(组别)及F_(时间×组别)中差异有统计学意义(P<0.05);研究组牙菌斑指数(1.97±0.46)分、(1.12±0.29)分,软垢指数(1.36±0.25)分、(1.16±0.10)分低于对照组牙菌斑指数(2.17±0.51)分、(1.28±0.43)分,软垢指数(1.88±0.29)分、(1.22±0.11)分(P<0.05);经重复测量方差分析,两组牙菌斑指数、软垢指数在护理前、护理3 d、5 d F_(时间)、F_(组别)及F_(时间×组别)中差异有统计学意义(P<0.05);研究组VAP发生率(1.85%)、机械通气时间(3.26±0.39)d、ICU住院时间(7.69±1.55)d低于对照组(14.81%)、(6.72±0.59)d、(13.21±2.30)d(P<0.05)。护理前,两组各项生活质量评分比较差异无统计学意义(P>0.05);出院3个月后,研究组生理机能(78.59±6.23)、精神健康(89.36±4.38)、一般健康状况精力(87.49±8.59)、生理职能(72.49±6.36)、情感职能(86.49±7.33)、社会功能(89.99±8.64)、总体健康Objective:To explore the effect of intensive care oral care frequency assessment scale(ICOCFAS)on oral care for patients with tracheal intubation and mechanical ventilation in intensive care unit(ICU)of neurology.Methods:108 patients with tracheal intubation and mechanical ventilation in ICU of Department of Neurology,Huai an First Hospital affiliated to Nanjing Medical University from June,2022 to December,2023 were randomly divided into two groups.The control group(n=54)received routine oral care,while the study group(n=54)received ICOCFAS score oral care on top of the care received by the control group,and the oral conditions were compared before nursing,after 3 days and 5 days of nursing.Plaque index and soft scale index;Incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation and hospitalization in ICU of neurology department.Results:Before nursing,there were no significant differences in oral health scores(2.39±0.60 vs 2.45±0.53)and oral odor scores(2.64±0.25 vs 2.60±0.29)between the two groups(P>0.05).After 3 and 5 days of nursing,the scores of oral health status(1.68±0.27),(1.29±0.19),oral odor(1.63±0.22)and(1.19±0.13)in the study group were lower than those in the control group(2.00±0.32).After repeated measurement analysis of variance,there were significant differences in oral health status and oral odor between the two groups before nursing,on the 3rd and 5th day of nursing,in F time,in F group and in F time×group(P<0.05).The plaque index(1.97±0.46),(1.12±0.29),soft scale index(1.36±0.25)and(1.16±0.10)in the study group were lower than those in the control group(2.17±0.51)and(1.28±0.43).After repeated measurement analysis of variance,the differences of plaque index and soft scale index between the two groups were statistically significant(P<0.05).The incidence of VAP(1.85%),the duration of mechanical ventilation(3.26±0.39)d and ICU stay(7.69±1.55)d in the study group were lower than those in the control group(14.81%),(6.72±0.59)d and(13.21±2.30)d(P<0.05);

关 键 词：重症监护口腔护理频率评估量表 口腔护理 神经内科重症监护室 气管内插管 机械通气 

分 类 号：R762[医药卫生—耳鼻咽喉科]