口腔冲刷护理预防糖尿病患者有创机械通气呼吸机相关性肺炎的应用研究  

An applied study of oral flushing care for the prevention of ventilator-associated pneumonia in diabetic patients on invasive mechanical ventilation

作　　者：符淑霞[1] 符琳 黎业钊 欧平雪 黄子高 劳景茂[2] 彭先美[1] FU Shuxia;FU Lin;LI Yezhao;OU Pingxue;HUANG Zigao;LAO Jingmao;PENG Xianmei(Department of Internal Medicine;Department of Gastrointestinal Surgery,The First People′s Hospital of Qinzhou,Qinzhou,Guangxi 535000,China)

机构地区：[1]钦州市第一人民医院大内科,广西钦州535000 [2]钦州市第一人民医院胃肠外科,广西钦州535000

出　　处：《现代医药卫生》2025年第3期674-679,共6页Journal of Modern Medicine & Health

基　　金：广西壮族自治区临床重点专科(普通外科)建设项目(桂卫医发[2022]17号);广西壮族自治区卫生健康委员会自筹经费科研课题(Z-N20221875)。

摘　　要：目的 探究口腔冲刷护理在预防糖尿病患者进行有创机械通气期间发生呼吸机相关性肺炎(VAP)的效果及应用价值。方法 选取2022年6月至2024年4月该院重症医学科收治的接受呼吸机辅助呼吸治疗的糖尿病患者122例作为研究对象,采用随机数字表法分为观察组和对照组,每组61例。对照组给予常规护理,观察组在常规护理基础上增加了口腔冲刷护理。比较2组患者有创机械通气时间、VAP发生率、总住院时间、临床转归、护理前后炎症指标、Beck口腔评分、口腔并发症发生率等。采用logistic回归模型分析有创机械通气糖尿病患者发生VAP的影响因素。结果 观察组患者护理后Beck口腔评分,以及口腔并发症、VAP发生率均明显低于对照组[(7.82±1.34)分vs.(9.83±1.40)分、22.95%(14/61)vs. 47.54%(29/61)、19.67%(12/61)vs. 36.07%(22/61)],差异均有统计学意义(P<0.05);重症监护病房糖尿病患者有创机械通气发生VAP与患者意识状态、Beck口腔评分、抗菌药物使用时间明显相关,差异均有统计学意义(P<0.05)。结论 口腔冲刷护理是一种简便、有效的方法,能显著提高有创机械通气糖尿病患者口腔卫生状况,降低VAP发生率,值得在临床进一步推广应用。Objective To explore the effectiveness and application value of oral flushing care in preventing ventilator-associated pneumonia(VAP)during invasive mechanical ventilation in diabetic patients.Methods A total of 122 cases of diabetic patients who received ventilator-assisted respiratory therapy admitted to the Department of Intensive Care Medicine of the hospital from June 2022 to April 2024 were selected as the study subjects,and were divided into the observation group and the control group by using the principle of allocation by random number table method,with 61 cases in each group.The control group was given routine care,and the observation group added oral flushing care on the basis of routine care.The time of invasive mechanical ventilation,incidence of VAP,total hospitalization time,clinical regression,inflammation indexes before and after care,Beck oral score,and incidence of oral complications were compared between the two groups.Logistic regression model was used to analyze the influencing factors for the occurrence of VAP in diabetic patients with invasive mechanical ventilation.Results The Beck oral score,as well as the incidence of oral complications and VAP in patients of the observation group were significantly lower than those in the control group after care[(7.82±1.34)points vs.(9.83±1.40)points,22.95%(14/61)vs.47.54%(29/61),19.67%(12/61)vs.36.07%(22/61)],and the differences were statistically significant(P<0.05);The occurrence of VAP in diabetic patients with invasive mechanical ventilation in the intensive care unit was significantly correlated with the patients′conscious state,Beck oral score,and the duration of antimicrobial drug use,and the differences were all statistically significant(P<0.05).Conclusion Oral flushing care is a simple and effective method to significantly improve oral hygiene and reduce the incidence of VAP in diabetic patients with invasive mechanical ventilation,which is worthy of further promotion and application in the clinic.

关 键 词：糖尿病 呼吸机相关性肺炎 口腔冲刷护理 有创机械通气 应用效果 

分 类 号：R587.1[医药卫生—内分泌] R563.1[医药卫生—内科学]